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Ohio 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 $6,026 · 10th–90th $1,000–$12,0230%10%10th90th$6,026Professionalmedian $1,514 · 10th–90th $347–$3,1620%10%20%10th90th$1,514$5.0$20.0$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
$691.83 / $6,025.60 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $1,698.24 / $4,365.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,949.84 / $5,888.44 / $15,135.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $1,202.26 / $2,570.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $724.44 / $2,691.53
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $758.58 / $2,691.53
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $6,918.31
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $977.24 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $9,332.54 / $14,125.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,288.25 / $3,019.95