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Maryland 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
$3,287.52 / $3,287.52 / $4,866.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.93 / $2,104.09 / $3,081.23
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.06 / $475.18 / $574.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,844.86 / $6,844.86 / $6,844.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.59 / $1,108.65 / $4,570.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,682.00 / $2,893.03 / $5,307.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,996.51 / $2,648.60 / $4,576.93
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.62 / $1,995.62 / $3,176.70