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Utah 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

Facilitymedian $6,761 · 10th–90th $3,162–$12,0230%10%10th90th$6,761Professionalmedian $2,089 · 10th–90th $447–$5,1290%10%10th90th$2,089$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $6,025.60 / $10,232.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $1,348.96 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $741.31 / $4,073.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $1,023.29 / $10,232.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $22,387.21 / $33,884.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,318.26 / $6,456.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $2,041.74 / $5,623.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $3,090.30 / $8,317.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $5,128.61 / $23,442.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $1,995.26 / $4,265.80