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New York 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
$549.54 / $4,073.80 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $1,445.44 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $9,772.37 / $18,620.87
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,905.46 / $5,128.61
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $1,995.26 / $16,595.87
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $2,754.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $616.60 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $1,318.26 / $4,466.84
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $489.78 / $1,230.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,691.53 / $3,630.78
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,995.26 / $3,235.94
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,570.40 / $2,884.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,456.54 / $16,595.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $1,584.89 / $3,801.89
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $457.09 / $602.56
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $1,698.24 / $3,019.95