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Utah 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
$363.08 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $338.84 / $426.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $60.26 / $1,174.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $512.86 / $549.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $537.03 / $741.31
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $371.54 / $436.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $302.00 / $489.78