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Maryland rates for HCPCS 36903

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; with transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis segment

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,751.69 / $2,751.69 / $5,828.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$283.06 / $1,647.53 / $6,225.86
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.79 / $334.27 / $397.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,752.00 / $7,752.00 / $7,752.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.86 / $791.91 / $9,250.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,105.17 / $5,340.90 / $9,982.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,701.26 / $6,305.90 / $9,776.18
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,140.22 / $4,140.22 / $5,855.96