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South Carolina 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
$1,223.43 / $7,799.00 / $17,697.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.93 / $2,104.09 / $3,093.64
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.81 / $447.81 / $726.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.79 / $706.14 / $3,423.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.05 / $1,166.40 / $2,584.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,259.11 / $8,259.11 / $10,613.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.96 / $1,246.21 / $4,309.76
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$516.11 / $2,387.11 / $4,593.31
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.87 / $7,307.35 / $8,938.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,869.85 / $2,378.35 / $3,563.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $20,474.00 / $33,299.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,268.87 / $3,131.04 / $5,688.94