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Vermont 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
$638.27 / $638.27 / $638.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.75 / $782.85 / $1,661.58
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.75 / $782.85 / $1,661.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.71 / $720.40 / $2,039.40