Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Thrombectomy and/or Infusion Dialysis Circuit
Smith, AR
See all hospitals reporting CPT 36904 →Price type
Mercy Hospital Fort Smith’s median price of $5.4k is 16% below the median hospital's median price ($6.4k), higher than 26% of the 1,983 hospitals reporting CPT 36904. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 17 payers, 37 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Medicaid hb ftsm ark medicaid facility · fee schedule · outpatient | $250 | $250 | — | — | — | $250 – $250 |
| 2 | Caresource hb ftsm caresource medicaid facility · fee schedule · outpatient | $255 | $255 | — | — | — | $255 – $255 |
| 3 | Blue Cross Blue Shield hb ftsm managed medicare facility · fee schedule · outpatient | $293 | $293 | — | — | — | $293 – $293 |
| 4 | Medicaid hb ftsm ark medicaid facility · case rate · outpatient | $297 | $297 | — | — | — | $297 – $297 |
| 5 | Caresource hb ftsm caresource medicaid facility · case rate · outpatient | $303 | $303 | — | — | — | $303 – $303 |
| 6 | Aetna hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 7 | Humana hb ftsm ok managed medicaid facility · percent of total billed charges · outpatientfrom % of charges | $2.7k | $2.7k | — | — | — | $2.7k – $2.7k |
| 8 | Blue Cross Blue Shield hb ftsm bcbs exchange facility · percent of total billed charges · outpatientfrom % of charges | $3.3k | $3.3k | — | — | — | $3.3k – $3.3k |
| 9 | Ambetter hb ftsm novasys ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges | $4.2k | $4.2k | — | — | — | $4.2k – $4.2k |
| 10 | Medicaid hb ftsm mo medicaid facility · fee schedule · outpatient | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 11 | Aetna hb ftsm ok managed medicaid facility · fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 12 | Humana hb ftsm ok managed medicaid facility · fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 13 | Medicaid hb ftsm ok medicaid facility · fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 14 | Aetna hb ftsm managed medicare facility · other · outpatient | $5.4k | $5.4k | — | — | 1–10 | $5.4k – $5.4k |
| 15 | Blue Cross Blue Shield hb ftsm managed medicare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 16 | First Health hb ftsm managed medicare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 17 | Humana hb ftsm humana mcr facility · other · outpatient | $5.4k | $5.4k | — | — | 1–10 | $5.4k – $5.4k |
| 18 | Medica hb ftsm managed medicare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 19 | Medicare hb ftsm medicare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 20 | Tricare hb ftsm tricare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 21 | UnitedHealthcare hb ftsm managed medicare facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 22 | UnitedHealthcare hb ftsm uhc mcr 100% facility · other · outpatient | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 23 | WellCare hb ftsm novasys mcr 103% facility · other · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 24 | Devoted hb ftsm devoted health mcr facility · other · outpatient | $5.6k | $5.6k | — | — | — | $5.6k – $5.6k |
| 25 | Cigna hb ftsm healthspring cigna mcr 105% facility · other · outpatient | $5.7k | $5.7k | — | — | — | $5.7k – $5.7k |
Last updated: Jun 8, 2026
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