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Nebraska 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
$3,548.13 / $7,943.28 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $1,698.24 / $3,548.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $10,715.19 / $20,892.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $1,412.54 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $1,122.02 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $2,884.03 / $9,549.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,630.78 / $6,606.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $3,715.35 / $5,370.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $776.25 / $3,801.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $7,585.78 / $9,772.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $2,344.23 / $4,466.84