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Biopsy of Upper Throat Behind the Nose

Nationwide rates for HCPCS 42804

This procedure takes a small tissue sample from the upper part of the throat located behind the nose, using an indirect technique such as a small scope or mirror rather than a larger open surgical approach. It is used to investigate symptoms such as nasal blockage, bleeding, or a visible growth in this area. The tissue sample is examined in a laboratory to check for infection, inflammation, or abnormal cells.

Rates data updated July 2026.

Facilitymedian $2,291 · 10th–90th $162$8,3180%10%10th90th$2,291Professionalmedian $204 · 10th–90th $115$4270%20%10th90th$204$0.5$5.0$50.0$500.0$5.0K$50.0K$500.0K

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
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$2,570.40
Typical High
$8,912.51
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$4,168.69
Typical High
$10,000.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$676.08
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$218.78
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$2,691.53
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$204.17
Typical High
$426.58