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Louisiana 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
$611.70 / $2,859.00 / $5,432.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.93 / $2,000.68 / $3,219.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.53 / $482.53 / $482.53
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,818.31 / $16,763.45 / $24,477.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.01 / $835.84 / $3,800.53
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,598.35 / $9,598.35 / $9,598.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$458.77 / $1,223.97 / $3,592.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,215.00 / $8,928.00 / $19,270.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,158.61 / $3,353.64 / $4,840.42