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Maine 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
$33,489.42 / $33,489.42 / $33,489.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.51 / $694.83 / $3,706.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.53 / $937.87 / $3,594.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.54 / $940.34 / $4,190.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.54 / $947.44 / $3,511.11
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,489.42 / $33,489.42 / $33,489.42
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.51 / $694.83 / $3,706.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,270.94 / $3,075.67 / $4,113.85