go back

New Mexico 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
$902.72 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.07 / $861.41 / $1,503.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.44 / $1,317.83 / $1,659.71
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,284.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.33 / $1,214.00 / $1,659.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.06 / $1,350.96 / $1,949.67