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Oklahoma 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
$1,000.00 / $2,630.27 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $524.81 / $758.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $630.96 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $707.95 / $851.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $1,412.54 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $575.44 / $3,311.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $1,949.84 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $549.54 / $794.33