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Indiana 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
$524.81 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $549.54 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $707.95 / $1,071.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $489.78 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $691.83 / $1,047.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $645.65 / $1,047.13