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Oklahoma 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
$1,288.25 / $3,890.45 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $1,288.25 / $2,290.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $3,019.95 / $4,897.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $1,778.28 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $562.34 / $2,570.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $3,981.07 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,137.96 / $13,182.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $7,762.47 / $14,125.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $1,348.96 / $2,454.71