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Montana rates for HCPCS 36906

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 transcatheter placement of intravascular stent(s), peripheral dialysis segment, including all imaging and radiological supervision and interpretation necessary to perform the stenting, and all angioplasty within the peripheral dialysis circuit

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.76 / $2,673.21 / $7,708.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.34 / $781.34 / $781.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.83 / $781.34 / $8,371.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.34 / $781.34 / $781.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.49 / $5,189.70 / $10,284.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,446.34 / $10,899.61 / $15,129.28