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Wyoming 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
$487.50 / $487.50 / $487.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,104.00 / $1,245.00 / $1,494.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.86 / $744.75 / $1,141.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.07 / $1,602.08 / $1,978.67