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Montana 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)

Facilitymedian $794 · 10th–90th $776–$8710%50%10th90th$794Professionalmedian $776 · 10th–90th $513–$1,5850%20%10th90th$776$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $616.60 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $707.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $794.33 / $870.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $794.33 / $870.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $707.95 / $812.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $446.68 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $794.33 / $1,949.84