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Maryland rates for HCPCS 0686T

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

Facilitymedian $8,913 · 10th–90th $603–$12,5890%20%10th90th$8,913Professionalmedian $3,715 · 10th–90th $2,188–$4,3650%20%10th90th$3,715$500.0$1.0K$2.0K$5.0K$10.0K$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,715.35 / $4,168.69
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $954.99 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $8,912.51 / $12,589.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $17,378.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,365.16 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,981.07 / $7,079.46