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Biopsy of Upper Throat Behind the Nose

California 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.

Facilitymedian $3,981 · 10th–90th $251$12,8820%5%10%10th90th$3,981Professionalmedian $204 · 10th–90th $112$5890%10%10th90th$204$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
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$6,025.60
Typical High
$16,982.44
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$204.17
Typical High
$707.95
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$4,466.84
Typical High
$12,022.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$186.21
Typical High
$389.05
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$3,801.89
Typical High
$7,079.46
Blue Shield
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$239.88
Typical High
$478.63
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,584.89
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$218.78
Typical High
$416.87
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$154.88
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$218.78
Typical High
$407.38
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$19,498.45
Typical High
$19,498.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$1,819.70
Typical High
$1,819.70
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$302.00
Optum
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$54.95
Typical High
$70.79
Providence
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$371.54
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$229.09
Typical High
$467.74
Sutter Health Plus
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$660.69
The Alliance
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$114.82
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$4,265.80
Typical High
$9,549.93
United
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$177.83
Typical High
$363.08