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Utah 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 $4,169 · 10th–90th $776–$6,0260%20%10th90th$4,169Professionalmedian $741 · 10th–90th $457–$1,3800%10%20%10th90th$741$50.0$200.0$1.0K$5.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $524.81 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $707.95 / $851.14
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $346.74 / $2,570.40
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $1,071.52 / $1,148.15
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $1,071.52 / $1,479.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $741.31 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $660.69 / $977.24