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New Mexico 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
$1,000.00 / $7,838.38 / $8,644.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.93 / $1,643.84 / $3,148.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,442.62 / $25,051.98 / $41,968.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.55 / $1,267.17 / $3,331.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.16 / $662.72 / $3,039.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $2,518.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.86 / $662.72 / $3,039.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,028.00 / $15,131.00 / $16,269.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,011.86 / $2,709.18 / $3,853.02