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Minnesota 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
$825.71 / $825.71 / $825.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$825.71 / $971.85 / $1,219.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.56 / $3,402.50 / $6,939.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,269.42 / $1,903.12 / $2,932.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.29 / $2,579.98 / $6,206.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,475.85 / $2,401.94 / $3,483.41
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,478.95 / $2,358.71 / $4,887.00
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,233.34 / $1,979.52 / $2,946.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,299.00 / $1,509.64 / $3,500.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.36 / $1,751.29 / $3,445.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,751.00 / $3,500.00 / $8,152.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,066.07 / $1,730.05 / $3,312.05