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North Carolina 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
$406.62 / $2,611.81 / $10,087.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.07 / $1,643.84 / $2,457.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.10 / $2,022.05 / $4,630.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$441.04 / $1,152.09 / $3,788.93
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.07 / $1,808.68 / $3,074.76
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,359.06 / $2,359.06 / $2,359.06
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.60 / $2,316.60 / $2,972.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,688.00 / $14,893.00 / $22,265.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,590.96 / $2,548.62 / $4,940.02
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,872.49 / $2,872.49
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,442.75 / $12,321.44 / $14,523.30