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New Hampshire 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 $5,495 · 10th–90th $2,399–$15,8490%10%10th90th$5,495Professionalmedian $1,122 · 10th–90th $372–$3,7150%5%10%10th90th$1,122$100.0$500.0$2.0K$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
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,890.45 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $891.25 / $2,951.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $5,495.41 / $8,511.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $977.24 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,071.52 / $5,248.07
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $12,302.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $1,905.46 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,995.26 / $6,606.93