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Washington, DC 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
$568.84 / $1,614.00 / $7,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.84 / $568.84 / $568.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.13 / $613.09 / $668.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$420.73 / $615.46 / $1,173.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.52 / $1,010.52 / $1,010.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $1,319.00 / $16,382.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.94 / $682.73 / $1,362.42