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Colorado rates for HCPCS 33955

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,551.00 / $5,503.00 / $10,651.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$911.67 / $911.67 / $1,318.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,434.00 / $5,126.00 / $9,729.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.41 / $1,090.95 / $1,580.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.93 / $1,240.44 / $1,630.17
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$911.67 / $1,043.01 / $1,531.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.41 / $1,189.80 / $1,529.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.00 / $8,535.00 / $12,740.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.16 / $1,350.96 / $2,264.44