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Oregon 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
$1,071.52 / $1,949.84 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,071.52 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,344.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,659.59 / $1,995.26
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,174.90 / $2,754.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $2,630.27
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,513.56 / $1,621.81
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,096.48 / $1,995.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,548.82 / $2,290.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,905.46 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $10,232.93 / $37,153.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,819.70 / $2,344.23