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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
$1,047.13 / $5,495.41 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $954.99 / $1,513.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $398.11 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,148.15 / $1,905.46
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $20,892.96 / $33,113.11
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $602.56 / $1,023.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,071.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $5,128.61 / $10,715.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,148.15 / $1,949.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $616.60 / $616.60