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Maine 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
$580.24 / $736.41 / $736.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.70 / $620.91 / $938.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.70 / $736.41 / $1,028.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.49 / $592.74 / $922.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.24 / $736.41 / $736.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.20 / $703.34 / $848.86