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New Jersey 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
$4,365.16 / $6,918.31 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $371.54 / $831.76
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $338.84 / $407.38
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $257.04 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $5,888.44 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $288.40 / $645.65