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Missouri 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
$228.68 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.94 / $219.74 / $228.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.37 / $285.82 / $368.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.58 / $274.13 / $506.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $370.17 / $6,335.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.44 / $318.86 / $1,295.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.44 / $283.86 / $541.75