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Alaska rates for HCPCS 33959

Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes fluoroscopic guidance, when performed)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$674.69 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,188.97 / $1,295.90 / $1,295.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.33 / $797.33 / $797.33
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.81 / $1,295.90 / $1,853.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.92 / $1,438.50 / $1,860.76
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.25 / $993.25 / $1,525.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.81 / $1,295.90 / $1,853.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.43 / $1,018.50 / $1,627.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$637.86 / $956.79 / $1,478.30