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Nebraska 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
$4,241.22 / $11,611.47 / $24,068.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.24 / $2,123.46 / $2,760.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,638.95 / $13,993.13 / $27,067.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.85 / $949.65 / $4,196.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.50 / $4,134.09 / $6,730.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.03 / $3,185.21 / $14,117.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,936.31 / $4,621.96 / $8,337.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.78 / $4,862.77 / $11,900.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$942.50 / $4,134.09 / $6,163.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,148.00 / $9,696.00 / $15,622.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,936.31 / $5,014.31 / $6,022.30