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West Virginia rates for HCPCS 0686T

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

Facilitymedian $3,715 · 10th–90th $1,413–$6,6070%20%40%10th90th$3,715Professionalmedian $3,715 · 10th–90th $2,884–$4,4670%20%40%10th90th$3,715$2.0K$5.0K$10.0K$20.0K$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
$1,412.54 / $3,715.35 / $3,715.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,715.35 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $17,378.01 / $17,378.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $20,417.38 / $47,863.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $3,981.07 / $6,760.83