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Utah 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)

Facilitymedian $4,169 · 10th–90th $794–$6,0260%20%10th90th$4,169Professionalmedian $776 · 10th–90th $479–$1,4450%10%10th90th$776$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $549.54 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $741.31 / $891.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $363.08 / $2,630.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,122.02 / $1,174.90
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,122.02 / $1,548.82
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $776.25 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $676.08 / $1,023.29