go back

Kentucky 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
$370.00 / $1,677.36 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.59 / $1,524.25 / $2,302.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,315.00 / $3,614.00 / $8,509.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.13 / $1,203.34 / $1,768.29
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.09 / $470.90 / $543.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.01 / $491.24 / $2,251.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.90 / $618.90 / $618.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.13 / $1,677.60 / $3,182.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$973.00 / $4,639.00 / $15,075.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,837.60 / $2,530.86 / $3,518.38