go back

California rates for HCPCS 0686T

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,498.00 / $8,756.00 / $20,509.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,615.56 / $3,643.73 / $4,362.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,516.00 / $4,576.00 / $11,456.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,356.96 / $1,614.78 / $2,537.51
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.50 / $197.33 / $4,123.53
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$752.67 / $2,765.99 / $6,627.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$643.00 / $5,662.00 / $31,695.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,665.76 / $6,665.76 / $6,665.76
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,171.92 / $13,171.92 / $13,830.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.67 / $2,496.26 / $6,299.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,792.60 / $53,287.10 / $53,287.10
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,371.29 / $27,944.72 / $33,483.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $85.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$858.24 / $3,817.70 / $5,948.36
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.67 / $1,252.56 / $6,446.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,859.28 / $12,859.28 / $13,512.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,266.57 / $4,262.89 / $9,239.07