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Arizona rates for HCPCS 0686T

Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance

Facilitymedian $4,266 · 10th–90th $1,778–$8,3180%5%10%10th90th$4,266Professionalmedian $3,715 · 10th–90th $2,399–$4,4670%20%10th90th$3,715$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

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
$2,089.30 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,715.35 / $4,365.16
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $2,884.03 / $5,370.32
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,047.13 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $10,471.29 / $17,378.01
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $3,801.89 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $4,265.80 / $6,760.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $16,595.87 / $28,183.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,265.80 / $6,025.60