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Texas rates for HCPCS 0686T

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

Facilitymedian $4,571 · 10th–90th $1,660$21,3800%10%10th90th$4,571Professionalmedian $3,715 · 10th–90th $2,344$4,4670%20%40%10th90th$3,715$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K$100.0K

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
$1,122.02 / $3,801.89 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,715.35 / $4,073.80
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11,748.98 / $19,952.62 / $40,738.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $12,302.69 / $13,489.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52,480.75 / $52,480.75 / $52,480.75
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,183.83 / $33,113.11 / $33,113.11
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,981.07 / $7,762.47
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,715.35 / $4,073.80
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,073.80 / $7,413.10
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $3,801.89 / $19,054.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $15,488.17 / $28,183.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,365.16 / $5,754.40
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $3,235.94 / $4,073.80