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Michigan rates for HCPCS 0686T

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

Facilitymedian $4,898 · 10th–90th $3,715–$15,1360%50%10th90th$4,898Professionalmedian $3,715 · 10th–90th $2,512–$6,0260%20%40%10th90th$3,715$1.0K$2.0K$5.0K$10.0K$20.0K$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
$3,715.35 / $4,897.79 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,630.78 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $17,378.01
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,897.79 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,630.78 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $16,595.87 / $47,863.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $4,570.88 / $5,754.40