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New Mexico 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
$537.67 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.84 / $495.44 / $894.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.24 / $761.51 / $959.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $764.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.82 / $723.23 / $959.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $3,503.00 / $15,732.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.55 / $809.45 / $1,159.91