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South Dakota 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 $2,089 · 10th–90th $380–$4,8980%10%20%10th90th$2,089Professionalmedian $1,820 · 10th–90th $372–$3,7150%5%10%10th90th$1,820$500.0$1.0K$2.0K$5.0K$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
$380.19 / $2,089.30 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $1,659.59 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,000.00 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $2,137.96 / $5,011.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,548.13 / $13,182.57
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $870.96 / $4,265.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $2,454.71 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $5,370.32 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,023.29 / $5,011.87
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $870.96 / $4,168.69