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Florida 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
$769.00 / $5,839.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.84 / $818.44 / $1,120.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$746.47 / $1,101.69 / $1,836.68
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,460.00 / $21,065.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.29 / $620.67 / $1,251.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$726.37 / $946.63 / $1,208.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$677.00 / $5,417.00 / $13,093.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.02 / $1,094.82 / $1,884.36
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.61 / $616.61 / $616.61