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New Jersey 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
$964.06 / $5,982.00 / $11,298.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.78 / $910.23 / $979.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.48 / $1,285.10 / $2,761.64
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,222.51 / $1,340.03 / $1,491.28
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.69 / $840.23 / $1,678.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,846.00 / $7,273.00 / $10,536.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$738.38 / $965.00 / $2,419.04