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Massachusetts rates for HCPCS 0686T

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

Facilitymedian $3,802 · 10th–90th $2,692–$5,6230%10%10th90th$3,802Professionalmedian $4,074 · 10th–90th $2,951–$9,3330%10%20%10th90th$4,074$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
$2,691.53 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $3,715.35 / $4,365.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $52,480.75
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $5,128.61 / $28,183.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $741.31 / $18,197.01
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $5,888.44 / $9,772.37
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $6,165.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,073.80 / $6,918.31 / $10,471.29
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $52,480.75
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $5,128.61 / $28,183.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $28,183.83 / $63,095.73
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,370.32 / $10,964.78