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Kansas 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
$1,930.00 / $7,655.00 / $13,151.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.74 / $579.37 / $757.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.36 / $734.54 / $734.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.94 / $708.00 / $1,109.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $864.37 / $4,857.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.04 / $741.51 / $3,281.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$783.00 / $1,743.00 / $8,198.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.74 / $741.51 / $1,015.27