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Pennsylvania rates for HCPCS 42804

Biopsy; nasopharynx, visible lesion, simple

Facilitymedian $2,570 · 10th–90th $234–$8,3180%5%10%10th90th$2,570Professionalmedian $200 · 10th–90th $115–$3980%20%10th90th$200$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$234.42 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $199.53 / $371.54
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,466.84 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $173.78 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $1,995.26 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $354.81
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $309.03 / $446.68
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,344.23 / $2,630.27
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $354.81
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18,620.87 / $18,620.87 / $18,620.87
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $1,584.89 / $6,606.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $213.80 / $575.44
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $389.05 / $489.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $173.78 / $309.03
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $213.80 / $407.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $2,630.27 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $177.83 / $316.23