go back

Minnesota rates for HCPCS 0686T

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,597.24 / $3,597.24 / $6,575.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,342.17 / $3,597.24 / $3,917.48
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26,814.26 / $42,184.96 / $74,202.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,052.39 / $10,052.39 / $18,736.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,216.67 / $5,801.30 / $9,101.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,262.89 / $7,089.99 / $14,343.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,262.89 / $7,063.09 / $14,343.69