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Missouri 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
$826.27 / $5,169.00 / $14,285.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.47 / $1,026.40 / $2,852.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,232.00 / $8,107.00 / $16,952.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.39 / $1,632.53 / $3,480.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,482.00 / $18,730.00 / $34,239.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.50 / $1,061.86 / $4,950.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.33 / $2,695.00 / $11,601.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,481.16 / $4,592.97 / $16,456.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,926.00 / $8,992.29 / $15,184.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,473.64 / $3,359.16 / $6,812.27