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Arkansas rates for HCPCS 33963

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $1,819.70 / $2,511.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $501.19 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $831.76 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $1,071.52 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $616.60 / $933.25