go back

New Mexico 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
$201.38 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.94 / $188.66 / $334.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.40 / $222.05 / $316.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.66 / $283.32 / $356.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $286.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.21 / $269.68 / $356.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.53 / $301.32 / $434.16