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Idaho rates for HCPCS 33962

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $302.00 / $691.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,047.13 / $1,230.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $426.58 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $389.05 / $457.09
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $478.63 / $4,466.84
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $407.38 / $467.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $457.09 / $489.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $426.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $15,488.17 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $338.84 / $489.78