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New Hampshire rates for HCPCS 36901

Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis and adjacent artery through entire venous outflow including the inferior or superior vena cava, fluoroscopic guidance, radiological supervision and interpretation and image documentation and report;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $8,965.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.63 / $415.55 / $658.46
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.00 / $154.00 / $154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.90 / $1,611.00 / $2,875.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.90 / $408.75 / $1,286.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.81 / $649.66 / $2,044.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.46 / $707.97 / $2,294.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,884.00 / $3,884.00 / $8,611.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.05 / $1,067.00 / $2,648.77
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.66 / $462.94 / $786.00