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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
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.15 / $408.15 / $2,402.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,424.93 / $17,657.45 / $34,155.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$390.93 / $666.36 / $888.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.21 / $1,012.40 / $1,373.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.39 / $841.34 / $5,805.80
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.82 / $1,006.68 / $1,311.68
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$814.67 / $1,005.82 / $1,373.03
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.16 / $1,012.40 / $1,373.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.82 / $1,006.68 / $1,256.78