go back

Massachusetts 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
$327.73 / $2,747.00 / $5,454.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.73 / $513.52 / $1,245.23
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$789.00 / $1,878.00 / $7,231.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.25 / $801.60 / $3,203.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.82 / $921.64 / $1,637.99
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $694.22 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.41 / $634.59 / $1,134.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.69 / $1,059.83 / $1,406.22
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,854.00 / $8,872.92
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.09 / $903.69 / $3,203.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.00 / $3,325.00 / $4,662.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.07 / $772.89 / $1,540.01