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Illinois 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 $1,202–$10,0000%5%10th90th$4,266Professionalmedian $3,715 · 10th–90th $2,344–$4,6770%20%10th90th$3,715$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
$1,202.26 / $3,801.89 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,630.78 / $4,073.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $24,547.09 / $29,512.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $588.84 / $18,197.01
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $199.53 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,511.89 / $2,511.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,595.87 / $16,595.87 / $41,686.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,786.30 / $7,079.46