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Biopsy of Upper Throat Behind the Nose

Connecticut 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 $4,677 · 10th–90th $2,754$8,5110%10%10th90th$4,677Professionalmedian $204 · 10th–90th $115$4470%5%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
$2,754.23
Median
$4,677.35
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$371.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$4,365.16
Typical High
$10,964.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$269.15
Typical High
$501.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$2,818.38
Typical High
$3,981.07
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$239.88
Typical High
$524.81
ConnectiCare
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
ConnectiCare
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$354.81
Typical High
$446.68
United
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$5,495.41
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$239.88
Typical High
$489.78