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Minnesota rates for HCPCS 33958

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.37 / $184.37 / $184.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.37 / $197.99 / $271.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.26 / $757.36 / $1,536.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.85 / $423.61 / $652.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$406.81 / $576.91 / $1,387.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.38 / $537.70 / $779.80
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$330.71 / $527.44 / $1,092.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.10 / $443.13 / $659.65
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.82 / $337.98 / $3,500.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.92 / $390.48 / $768.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,751.00 / $3,500.00 / $8,152.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.30 / $421.37 / $725.08