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New Mexico rates for HCPCS 0686T

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

Facilitymedian $4,074 · 10th–90th $1,288–$10,9650%20%10th90th$4,074Professionalmedian $3,802 · 10th–90th $2,884–$4,3650%50%10th90th$3,802$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
$2,041.74 / $7,762.47 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,715.35 / $4,365.16
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56,234.13 / $69,183.10 / $81,283.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,220.18 / $11,220.18 / $11,220.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $60.26 / $85.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $3,801.89 / $6,456.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $6,456.54 / $19,054.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33,884.42 / $39,810.72 / $74,131.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,265.80 / $6,918.31