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Minnesota 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
$467.74 / $467.74 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $549.54 / $812.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,905.46 / $6,918.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,000.00 / $1,659.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,548.82 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,318.26 / $1,995.26
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,479.11 / $2,951.21
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $1,698.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $954.99 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $933.25 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,467.37 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $954.99 / $1,862.09