go back

Utah 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

Facilitymedian $4,169 · 10th–90th $1,380–$6,0260%20%10th90th$4,169Professionalmedian $1,288 · 10th–90th $794–$2,4550%10%20%10th90th$1,288$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $933.25 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,258.93 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $616.60 / $4,677.35
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,905.46 / $2,041.74
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,905.46 / $2,630.27
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,288.25 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,174.90 / $1,737.80