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Idaho 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
$1,621.81 / $5,495.41 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $2,089.30 / $5,128.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $12,589.25 / $30,199.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $3,388.44 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $891.25 / $4,677.35
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $2,754.23 / $8,511.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $2,187.76 / $4,365.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,952.62 / $25,118.86 / $37,153.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $912.01 / $4,897.79
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $2,041.74 / $26,302.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $17,782.79 / $19,054.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $1,995.26 / $4,073.80