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Alaska rates for HCPCS 33951

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,225.05 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,154.40 / $2,352.96 / $2,352.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,446.74 / $1,446.74 / $1,446.74
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.79 / $2,352.96 / $3,364.75
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.93 / $2,601.90 / $3,364.40
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.75 / $1,796.55 / $2,760.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.79 / $2,352.96 / $3,364.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.64 / $1,846.50 / $2,902.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,157.40 / $1,736.10 / $2,678.86