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Massachusetts 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
$331.13 / $3,388.44 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $602.56 / $2,089.30
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,862.09 / $7,244.36
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $741.31 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,000.00 / $1,737.80
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $724.44 / $8,511.38
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $630.96 / $1,096.48
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,311.31 / $5,888.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $676.08 / $1,230.27
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,862.09 / $7,244.36
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $741.31 / $1,737.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,884.03 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $851.14 / $1,479.11