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Minnesota 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
$489.78 / $489.78 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $575.44 / $831.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,995.26 / $7,079.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,071.52 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,621.81 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,380.38 / $2,089.30
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,548.82 / $3,019.95
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,174.90 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $954.99 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,467.37 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,000.00 / $1,905.46