Primary percutaneous transluminal mechanical thrombectomy, noncoronary, non-intracranial, arterial or arterial bypass graft, including fluoroscopic guidance and intraprocedural pharmacological thrombolytic injection(s); second and all subsequent vessel(s) within the same vascular family (List separately in addition to code for primary mechanical thrombectomy procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $153.87 | $246.57 | $905.62 | |
Anthem BCBS
| Professional | $196.84 | $344.73 | $757.49 | |
Cigna
| Professional | $207.33 | $600.60 | $1,076.11 | |
Harvard Pilgrim
| Professional | $176.26 | $348.25 | $742.16 | |
Martin's Point
| Professional | $153.87 | $246.57 | $905.62 | |
United
| Professional | $762.39 | $986.67 | $1,190.81 |