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Montana 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);

Facilitymedian $2,884 · 10th–90th $603–$3,3880%20%10th90th$2,884Professionalmedian $1,660 · 10th–90th $407–$4,3650%10%10th90th$1,660$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,659.59 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $562.34 / $2,818.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $2,884.03 / $3,388.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $2,884.03 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $660.69 / $3,019.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $562.34 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $1,318.26 / $3,801.89