go back

New Jersey 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
$4,365.16 / $8,511.38 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $1,479.11 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $1,202.26 / $4,570.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $2,691.53 / $3,311.31
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,481.54 / $19,054.61 / $28,840.32
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $1,778.28 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $9,772.37 / $25,118.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $1,479.11 / $3,801.89