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Oregon 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
$724.44 / $4,073.80 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $1,288.25 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $1,698.24 / $5,248.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $912.01 / $4,365.16
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $2,630.27 / $15,848.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $1,819.70 / $4,897.79
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $3,388.44 / $3,630.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $1,737.80 / $4,265.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $977.24 / $4,897.79
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,803.84 / $18,197.01 / $22,387.21
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,230.27 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $20,892.96 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $2,137.96 / $4,786.30