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Alaska rates for HCPCS 33953

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $12,022.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $602.56 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $691.83 / $3,715.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,380.38 / $3,162.28
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,862.09 / $2,630.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $2,630.27 / $3,715.35
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $457.09 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,288.25 / $3,019.95