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Delaware 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
$1,122.02 / $5,888.44 / $6,606.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $1,230.27 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $501.19 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $1,819.70 / $2,691.53