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Biopsy of Upper Throat Behind the Nose

Hawaii 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.

How much does Biopsy of Upper Throat Behind the Nose cost?

$3,093

Typical total for the visit. In Hawaii, July 2026.

Insurers have agreed to pay about $3,093 for this procedure. That total is two separate charges: $209 to the doctor who performs it, and $2,884 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$209$132 to $537
Facility feeThe hospital or surgery center$2,884$1,000 to $2,884

How much rates vary

Facilitymedian $2,884 · 10th to 90th $813 to $2,884Professionalmedian $209 · 10th to 90th $115 to $2,570
$100$200$500$1K$2Kfacility $2,884professional $209

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$2,884.03
Typical High
$2,884.03
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$173.78
Typical High
$245.47
Cigna
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$229.09
Typical High
$602.56
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$234.42
Typical High
$331.13
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$1,737.80
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$295.12
University Health Alliance
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$1,513.56
Typical High
$3,981.07

Where Hawaii sits

The same service costs 17.1 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Hawaii· 12th of 50

$3,093

$209 physician + $2,884 facility

IN $6,340WV $370

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.