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Arizona rates for HCPCS 36905

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); with transluminal balloon angioplasty, peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $9,618.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.93 / $2,259.17 / $3,519.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.68 / $369.68 / $369.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,805.25 / $7,403.60 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.62 / $1,484.47 / $2,429.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,958.31 / $11,958.31 / $11,958.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.50 / $1,106.03 / $3,408.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.84 / $2,505.29 / $13,761.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,118.60 / $2,612.48 / $8,337.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,560.00 / $10,316.00 / $16,841.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,054.40 / $2,475.01 / $3,858.70