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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
$492.23 / $492.23 / $492.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.23 / $579.23 / $726.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$943.09 / $2,027.65 / $4,082.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.87 / $1,134.11 / $1,747.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,084.83 / $1,538.43 / $3,700.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.66 / $1,431.65 / $2,076.25
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$881.89 / $1,406.50 / $2,914.10
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.12 / $1,179.86 / $1,756.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$774.10 / $899.62 / $3,500.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.23 / $1,042.71 / $2,051.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.00 / $3,236.00 / $5,530.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.30 / $1,029.96 / $1,972.23