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North Carolina rates for HCPCS 0686T

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

Facilitymedian $4,266 · 10th–90th $2,754–$10,4710%20%10th90th$4,266Professionalmedian $4,467 · 10th–90th $100–$9,5500%10%10th90th$4,467$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
$1,698.24 / $8,511.38 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,548.13 / $4,168.69
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $11,481.54 / $12,882.50
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $5,495.41 / $11,220.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $10,964.78 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,890.45 / $6,025.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $15,135.61 / $28,183.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,365.16 / $7,079.46
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $52,480.75
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $28,183.83 / $33,113.11