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North Carolina 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
$179.35 / $281.72 / $7,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.35 / $179.35 / $281.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.25 / $539.69 / $798.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.94 / $313.86 / $524.58
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.97 / $265.33 / $374.84
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.33 / $265.33 / $265.33
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.23 / $214.38 / $277.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.00 / $4,086.00 / $7,778.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.83 / $270.45 / $698.97
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,505.16 / $1,813.50
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,267.59 / $1,537.80 / $1,537.80