| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,511.89 | $3,715.35 | $4,073.80 | |
United
| Facility | $16,982.44 | $16,982.44 | $16,982.44 | |
United
| Professional | $3,981.07 | $6,025.60 | $12,882.50 |
Histotripsy (ie, non-thermal ablation via acoustic energy delivery) of malignant hepatocellular tissue, including image guidance
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2,511.89 | $3,715.35 | $4,073.80 | |
United
| Facility | $16,982.44 | $16,982.44 | $16,982.44 | |
United
| Professional | $3,981.07 | $6,025.60 | $12,882.50 |