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Washington, DC rates for HCPCS 36904

Percutaneous transluminal mechanical thrombectomy and/or infusion for thrombolysis, dialysis circuit, any method, including all imaging and radiological supervision and interpretation, diagnostic angiography, fluoroscopic guidance, catheter placement(s), and intraprocedural pharmacological thrombolytic injection(s);

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $4,100.00 / $7,007.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.10 / $446.10 / $2,444.82
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.65 / $412.73 / $13,025.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.44 / $907.44 / $2,881.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.30 / $4,217.28 / $4,217.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,062.00 / $5,185.00 / $19,046.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,358.12 / $2,528.67 / $5,685.94