go back

Wyoming 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
Professional
Modifier
Low / Median / High Price
$818.57 / $818.57 / $818.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,853.00 / $2,089.00 / $2,507.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,246.26 / $1,287.78 / $1,977.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,275.00 / $1,275.00 / $3,239.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.67 / $2,692.91 / $3,429.37