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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $391.51 | $2,104.09 | $2,565.98 | |
BCBS
| Facility | $47,000.00 | $81,499.99 | $94,999.99 | |
BCBS
| Professional | $676.70 | $676.70 | $676.70 | |
Cigna
| Facility | $676.70 | $676.70 | $676.70 | |
Cigna
| Professional | $553.49 | $676.70 | $3,514.97 | |
Providence
| Facility | $676.70 | $676.70 | $676.70 | |
Providence
| Professional | $452.85 | $2,169.35 | $4,315.45 | |
United
| Professional | $3,274.20 | $4,108.79 | $6,348.27 |