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Nebraska 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
$758.58 / $7,943.28 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $524.81 / $2,089.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,489.63 / $17,378.01 / $33,884.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $588.84 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $912.01 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $758.58 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $851.14 / $1,174.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $954.99 / $1,288.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $4,570.88 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,096.48