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Colorado 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
$2,551.00 / $5,503.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.99 / $514.99 / $743.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,434.00 / $5,126.00 / $9,729.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.06 / $615.76 / $891.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.34 / $699.19 / $919.22
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.99 / $589.17 / $865.18
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.34 / $672.10 / $864.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,506.00 / $8,565.00 / $14,156.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.88 / $783.58 / $1,224.34