go back

Rhode Island 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
$2,993.72 / $3,706.14 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,489.01 / $3,873.14 / $4,705.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$680.00 / $680.00 / $17,459.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,893.14 / $1,893.14 / $1,893.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,738.29 / $4,683.10 / $7,334.93