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Connecticut 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
$1,513.56 / $4,897.79 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $977.24 / $1,949.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,168.69 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,819.70 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,412.54 / $2,238.72
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,513.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $6,165.95 / $15,135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,412.54 / $2,630.27