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North Dakota 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
$801.58 / $801.58 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$801.58 / $801.58 / $846.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,559.16 / $1,689.43 / $1,996.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.05 / $1,418.75 / $2,290.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$801.58 / $1,086.21 / $2,404.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.27 / $1,576.73 / $2,051.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.68 / $1,679.38 / $2,051.06