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New Mexico 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
$1,000.00 / $7,838.38 / $8,942.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.93 / $2,176.76 / $3,324.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,106.07 / $50,633.70 / $78,571.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.94 / $2,028.79 / $3,812.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.20 / $799.59 / $3,888.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,822.86 / $3,150.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.16 / $799.59 / $3,888.91
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,609.00 / $21,608.00 / $23,186.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,824.80 / $3,530.98 / $5,071.81