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Delaware 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
$6,907.00 / $6,907.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.62 / $903.62 / $978.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.45 / $1,145.42 / $1,301.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.32 / $1,167.74 / $2,138.32