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Wisconsin 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 $12,882 · 10th–90th $3,467–$20,4170%10%10th90th$12,882Professionalmedian $1,820 · 10th–90th $407–$6,0260%5%10th90th$1,820$50.0$200.0$1.0K$5.0K$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
$446.68 / $2,344.23 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $1,288.25 / $2,951.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $13,803.84 / $21,877.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $2,290.87 / $7,762.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $5,623.41 / $8,912.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $1,258.93 / $6,456.54
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $2,630.27 / $4,786.30
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,230.27 / $5,128.61
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $8,709.64 / $16,595.87
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,801.89 / $9,549.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,715.19 / $17,378.01
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,511.89 / $8,511.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,949.84 / $6,025.60
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $13,489.63 / $19,952.62
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $3,715.35 / $12,302.69
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $9,772.37
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $8,709.64 / $12,589.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $14,125.38 / $17,378.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $1,995.26 / $7,585.78