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Biopsy of Upper Throat Behind the Nose

Arkansas 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?

$1,361

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

Insurers have agreed to pay about $1,361 for this procedure. That total is two separate charges: $186 to the doctor who performs it, and $1,175 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$186$129 to $224
Facility feeThe hospital or surgery center$1,175$589 to $2,570

How much rates vary

Facilitymedian $1,175 · 10th to 90th $204 to $2,884Professionalmedian $186 · 10th to 90th $115 to $263
$100$200$500$1K$2K$5Kfacility $1,175professional $186

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
$144.54
Median
$794.33
Typical High
$1,862.09
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$177.83
Typical High
$251.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,884.03
Median
$2,884.03
Typical High
$3,981.07
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$363.08
Median
$512.86
Typical High
$1,737.80
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$199.53
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$1,445.44
Typical High
$6,165.95
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$186.21
Typical High
$323.59

Where Arkansas 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

Arkansas· 33rd of 50

$1,361

$186 physician + $1,175 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.