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Illinois rates for HCPCS 42804

Biopsy; nasopharynx, visible lesion, simple

Facilitymedian $1,995 · 10th–90th $219–$5,6230%5%10th90th$1,995Professionalmedian $204 · 10th–90th $117–$3720%10%10th90th$204$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
$218.78 / $1,862.09 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $204.17 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $4,168.69 / $5,623.41
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $213.80 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $1,000.00 / $2,691.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $213.80 / $398.11
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $323.59 / $741.31
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
$147.91 / $151.36 / $281.84
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,818.38 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $199.53 / $346.74