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Biopsy of Upper Throat Behind the Nose

Arizona 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?

$1,928

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

Insurers have agreed to pay about $1,928 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $1,738 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$191$129 to $234
Facility feeThe hospital or surgery center$1,738$245 to $3,467

How much rates vary

Facilitymedian $1,738 · 10th to 90th $148 to $5,623Professionalmedian $191 · 10th to 90th $112 to $363
$100$200$500$1K$2K$5Kfacility $1,738professional $191

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
$1,445.44
Median
$3,715.35
Typical High
$6,606.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$1,698.24
Typical High
$3,311.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$245.47
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$1,584.89
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$371.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$630.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$275.42
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$977.24
Median
$2,398.83
Typical High
$4,677.35
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$177.83
Typical High
$309.03

Where Arizona 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

Arizona· 23rd of 50

$1,928

$191 physician + $1,738 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.