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Florida 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
$769.00 / $5,495.04 / $12,669.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.92 / $1,297.76 / $2,020.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $3,504.45 / $4,171.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.94 / $866.49 / $2,810.28
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,855.00 / $12,685.00 / $23,031.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,120.08 / $1,200.08 / $2,420.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,244.07 / $1,854.25 / $2,461.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,072.00 / $12,207.00 / $18,694.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,463.94 / $2,101.88 / $3,658.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.73 / $1,315.69 / $1,315.69