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California rates for HCPCS 33964

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $10,471.29 / $22,908.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $2,454.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $13,803.84 / $22,908.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,096.48 / $1,995.26
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $100.00 / $1,862.09
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $724.44 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $616.60 / $1,584.89
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $467.74 / $588.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $512.86 / $1,000.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $11,220.18
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $4,073.80 / $4,073.80
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $602.56 / $851.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $630.96 / $1,479.11
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $457.09 / $602.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $6,165.95 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $630.96 / $1,318.26