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Florida rates for HCPCS 0686T

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

Facilitymedian $5,754 · 10th–90th $1,445–$11,4820%10%10th90th$5,754Professionalmedian $3,631 · 10th–90th $2,291–$4,3650%20%10th90th$3,631$100.0$500.0$2.0K$10.0K$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
$1,445.44 / $5,754.40 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,630.78 / $4,073.80
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $17,782.79 / $17,782.79
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $9,332.54 / $10,471.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,890.45 / $7,413.10
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $912.01 / $1,000.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $19,952.62 / $28,183.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,630.78 / $5,754.40
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,412.54 / $1,412.54