go back

Indiana 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
$616.60 / $3,890.45 / $19,054.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $1,621.81 / $3,548.13
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $38,904.51 / $52,480.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $1,548.82 / $3,090.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $446.68 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $2,344.23 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $1,995.26 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $13,803.84 / $20,417.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $1,862.09 / $4,265.80