go back

New Hampshire 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
$100.00 / $2,331.21 / $22,533.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.87 / $760.31 / $2,619.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,667.39 / $5,186.00 / $8,238.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.53 / $1,041.03 / $4,107.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.62 / $1,794.57 / $7,100.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.71 / $2,389.55 / $7,375.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,629.00 / $12,629.00 / $12,629.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,340.12 / $4,359.88 / $9,275.14
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.78 / $1,836.86 / $3,083.80