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Idaho rates for HCPCS 0686T

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

Facilitymedian $4,467 · 10th–90th $3,388–$35,4810%20%10th90th$4,467Professionalmedian $3,802 · 10th–90th $2,884–$4,4670%50%10th90th$3,802$50.0$200.0$1.0K$5.0K$20.0K

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
$3,388.44 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,715.35 / $4,365.16
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23,988.33 / $34,673.69 / $57,543.99
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,888.44 / $6,165.95
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,890.45 / $6,456.54
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,801.89 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26,302.68 / $37,153.52 / $57,543.99
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $5,888.44 / $6,918.31
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $3,235.94 / $43,651.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,265.80 / $6,918.31