go back

Georgia 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
$4,365.16 / $5,888.44 / $9,549.93
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
$1,071.52 / $2,884.03 / $4,786.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,412.54 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,380.38 / $2,238.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,023.29 / $7,585.78
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $3,235.94 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,348.96 / $2,187.76