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Iowa 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
$4,277.00 / $5,549.00 / $11,100.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$509.35 / $696.92 / $696.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.64 / $1,101.88 / $1,237.03
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.01 / $698.22 / $1,716.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.69 / $1,177.79 / $6,608.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.69 / $1,075.18 / $1,830.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$743.16 / $1,064.08 / $1,373.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.00 / $1,005.82 / $1,373.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,126.00 / $5,847.00 / $7,305.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.15 / $913.86 / $1,446.30
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$728.46 / $922.10 / $1,084.90