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South Dakota rates for HCPCS 0686T

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

Facilitymedian $3,631 · 10th–90th $1,622–$6,0260%20%10th90th$3,631Professionalmedian $3,715 · 10th–90th $3,467–$4,5710%20%40%10th90th$3,715$1.0K$2.0K$5.0K$10.0K

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
$3,630.78 / $3,630.78 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,715.35 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $4,897.79 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,630.78 / $5,011.87 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,897.79 / $8,128.31