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Maryland 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
Professional
Modifier
Low / Median / High Price
$478.63 / $588.84 / $891.25
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $524.81 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $630.96 / $1,230.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $524.81 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $588.84 / $1,071.52
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $549.54 / $741.31