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Maine rates for HCPCS 0686T

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

Facilitymedian $692 · 10th–90th $692–$6920%50%100%$692Professionalmedian $4,074 · 10th–90th $2,512–$8,9130%10%20%10th90th$4,074$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,715.35 / $4,365.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,412.54 / $2,818.38
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,677.35 / $6,456.54 / $11,220.18
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,715.35 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,890.45 / $4,897.79 / $9,549.93