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Maryland rates for HCPCS 0072T

Focused ultrasound ablation of uterine leiomyomata, including MR guidance; total leiomyomata volume greater or equal to 200 cc of tissue

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.64 / $830.49 / $1,830.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.28 / $790.40 / $4,250.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,489.25 / $2,135.16 / $3,652.91