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Vermont 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
Professional
Modifier
Low / Median / High Price
$426.16 / $426.16 / $2,251.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.72 / $2,451.92 / $6,692.73
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.72 / $2,451.92 / $6,692.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,556.42 / $2,712.12 / $8,214.57