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Biopsy of Upper Throat Behind the Nose

Georgia 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 $2,884 · 10th–90th $372$7,2440%10%10th90th$2,884Professionalmedian $209 · 10th–90th $120$3720%20%10th90th$209$10.0$50.0$200.0$1.0K$5.0K

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
$218.78
Median
$3,630.78
Typical High
$7,413.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$354.81
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$107.15
Typical High
$107.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$1,949.84
Typical High
$5,128.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$257.04
Typical High
$416.87
CareSource
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Cigna
Setting
Facility
Modifier
Global
Typical Low
$380.19
Median
$645.65
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$208.93
Typical High
$436.52
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$239.88
Typical High
$380.19
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$416.87
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$2,454.71
Typical High
$5,248.07
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$363.08