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Florida 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
$461.06 / $5,839.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.79 / $461.06 / $632.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.65 / $620.99 / $1,034.52
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,460.00 / $21,065.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.12 / $350.49 / $706.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.97 / $529.51 / $674.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$677.00 / $5,417.00 / $13,093.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.51 / $616.37 / $1,062.83
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.26 / $348.26 / $348.26