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West Virginia 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
$516.61 / $516.61 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.61 / $538.36 / $600.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$514.36 / $590.14 / $642.96
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.52 / $571.52 / $571.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.54 / $552.54 / $552.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.41 / $759.33 / $2,241.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.00 / $765.00 / $765.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.53 / $670.46 / $1,041.27