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Washington rates for HCPCS 0686T

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

Facilitymedian $13,183 · 10th–90th $3,311–$48,9780%10%10th90th$13,183Professionalmedian $3,890 · 10th–90th $2,570–$6,3100%20%40%10th90th$3,890$50.0$200.0$1.0K$5.0K$20.0K$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
$4,466.84 / $13,182.57 / $21,877.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $3,715.35 / $4,365.16
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30,199.52 / $47,863.01 / $100,000.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,244.36 / $10,000.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $954.99 / $26,915.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,589.25 / $33,884.42 / $57,543.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,589.25 / $12,589.25 / $12,589.25
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $60.26 / $79.43
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,311.31 / $12,882.50
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,549.93 / $13,803.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33,884.42 / $48,977.88 / $100,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,244.36 / $9,332.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,197.01 / $60,255.96 / $102,329.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,265.80 / $8,511.38
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,445.44 / $5,248.07