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Biopsy of Upper Throat Behind the Nose

Alabama 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.

How much does Biopsy of Upper Throat Behind the Nose cost?

$1,679

Typical total for the visit. In Alabama, July 2026.

Insurers have agreed to pay about $1,679 for this procedure. That total is two separate charges: $200 to the doctor who performs it, and $1,479 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$200$126 to $245
Facility feeThe hospital or surgery center$1,479$1,072 to $1,862

How much rates vary

Facilitymedian $1,479 · 10th to 90th $617 to $2,512Professionalmedian $200 · 10th to 90th $112 to $398
$100$200$500$1K$2K$5Kfacility $1,479professional $200

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$954.99
Typical High
$2,398.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$199.53
Typical High
$416.87
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$1,513.56
Typical High
$2,041.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$169.82
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,778.28
Typical High
$3,388.44
United
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$169.82
Typical High
$295.12

Where Alabama sits

The same service costs 17.1 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Alabama· 30th of 50

$1,679

$200 physician + $1,479 facility

IN $6,340WV $370

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.