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Nebraska rates for HCPCS 33969

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.29 / $235.29 / $1,385.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,424.93 / $17,657.45 / $34,155.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.38 / $384.19 / $512.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.72 / $583.71 / $790.65
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$299.99 / $499.30 / $4,406.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.94 / $595.28 / $778.59
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.70 / $581.23 / $790.65
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.84 / $583.71 / $790.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.93 / $582.63 / $699.86