go back

Wyoming 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
$380.19 / $1,047.13 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $794.33 / $4,073.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $6,918.31 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $1,318.26 / $6,165.95