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Rhode Island 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
$3,467.37 / $3,715.35 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $1,230.27 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $724.44 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $977.24 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $7,762.47 / $13,489.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $1,412.54 / $2,951.21