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Virginia 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 $4,365 · 10th–90th $447–$11,7490%5%10th90th$4,365Professionalmedian $1,660 · 10th–90th $380–$3,0900%10%10th90th$1,660$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$630.96 / $5,011.87 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,479.11 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $8,709.64 / $12,022.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $1,047.13 / $2,754.23
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $7,585.78 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $933.25 / $3,162.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $2,041.74 / $2,511.89
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $4,570.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $1,548.82 / $3,467.37
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $489.78 / $11,481.54
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,454.71 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $11,748.98 / $26,302.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,258.93 / $3,388.44