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Tennessee 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
$850.71 / $3,106.69 / $6,681.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$325.93 / $1,579.40 / $3,106.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,056.00 / $5,467.00 / $9,283.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.33 / $1,175.01 / $3,281.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.19 / $1,146.66 / $3,393.64
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,872.49 / $3,172.90
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,442.75 / $12,321.44 / $14,523.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,964.00 / $8,273.00 / $19,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,629.70 / $2,501.42 / $4,337.24