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Pennsylvania 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 $1,380–$10,7150%10%10th90th$6,026Professionalmedian $1,698 · 10th–90th $363–$2,5120%20%10th90th$1,698$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$1,380.38 / $6,165.95 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $1,659.59 / $2,454.71
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,125.38 / $14,125.38 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,691.53 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $724.44 / $3,162.28
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,019.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $2,290.87 / $3,090.30
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,481.54 / $11,481.54 / $15,488.17
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $4,786.30 / $8,709.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $1,445.44 / $2,691.53
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $2,089.30 / $2,089.30
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $389.05 / $1,862.09
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $416.87 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $6,309.57 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,318.26 / $3,019.95