go back

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
$794.33 / $831.76 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $831.76 / $1,318.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,737.80 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,380.38 / $2,290.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,096.48 / $2,398.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,513.56 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,513.56 / $1,995.26