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Biopsy of Upper Throat Behind the Nose

Colorado 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 $3,236 · 10th–90th $148$8,1280%5%10th90th$3,236Professionalmedian $200 · 10th–90th $117$3470%10%10th90th$200$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$223.87
Median
$3,981.07
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$309.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$6,760.83
Typical High
$10,964.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$223.87
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$891.25
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$218.78
Typical High
$371.54
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$218.78
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$223.87
Typical High
$602.56
Select Health
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$234.42
Typical High
$478.63
Select Health
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$134.90
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,258.93
Median
$3,311.31
Typical High
$6,309.57
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$371.54