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Indiana rates for HCPCS 0686T

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

Facilitymedian $21,380 · 10th–90th $4,898–$31,6230%10%10th90th$21,380Professionalmedian $3,467 · 10th–90th $1,445–$4,3650%20%10th90th$3,467$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
$1,380.38 / $4,897.79 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,548.13 / $4,168.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $25,703.96 / $32,359.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,445.44 / $2,344.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $56,234.13 / $89,125.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $6,606.93 / $12,589.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $17,378.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,265.80 / $6,456.54