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Illinois rates for HCPCS 42800

Biopsy; oropharynx

Facilitymedian $1,622 · 10th–90th $204–$5,6230%5%10th90th$1,622Professionalmedian $174 · 10th–90th $112–$3470%10%10th90th$174$20.0$100.0$500.0$2.0K$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
$204.17 / $1,621.81 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $138.04 / $229.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $1,995.26 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $177.83 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $194.98 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $186.21 / $338.84
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $245.47 / $602.56
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $147.91 / $213.80
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $33.11 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,412.54 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $169.82 / $281.84