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Nebraska 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
$851.14 / $7,943.28 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $588.84 / $2,344.23
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
$389.05 / $660.69 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,000.00 / $1,380.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $831.76 / $7,943.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $954.99 / $1,318.26
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,071.52 / $1,445.44
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $954.99
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
$645.65 / $912.01 / $1,202.26