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Biopsy of Upper Throat Behind the Nose

Washington, DC 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 $1,698 · 10th–90th $269$7,7620%10%10th90th$1,698Professionalmedian $170 · 10th–90th $117$2690%10%20%10th90th$170$100.0$500.0$2.0K$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
$269.15
Median
$1,698.24
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$151.36
Typical High
$269.15
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$131.83
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$524.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$208.93
Median
$245.47
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$6,606.93
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$194.98
Typical High
$407.38