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Utah 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)

Facilitymedian $4,169 · 10th–90th $295–$6,0260%20%10th90th$4,169Professionalmedian $263 · 10th–90th $178–$5500%10%20%10th90th$263$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $208.93 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $275.42 / $338.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $138.04 / $1,071.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $416.87 / $436.52
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $426.58 / $588.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $251.19 / $309.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $389.05