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Massachusetts 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
$1,297.76 / $2,809.00 / $6,075.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.04 / $1,297.76 / $2,913.18
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$784.49 / $4,671.00 / $13,017.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$377.15 / $2,640.44 / $6,768.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.90 / $525.07 / $1,029.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.92 / $1,903.31 / $5,830.32
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.32 / $524.64 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,151.19 / $2,535.17 / $4,532.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.73 / $2,110.67 / $5,256.83
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,097.00 / $14,018.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,440.92 / $4,270.33 / $12,321.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,386.00 / $5,904.00 / $13,017.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,186.38 / $2,946.98 / $6,768.99