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Biopsy of Upper Throat Behind the Nose

Iowa 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 $2,239 · 10th–90th $209$6,7610%5%10%10th90th$2,239Professionalmedian $214 · 10th–90th $117$5130%20%10th90th$214$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
$208.93
Median
$2,511.89
Typical High
$6,760.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$426.58
Cigna
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$309.03
Typical High
$630.96
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$323.59
Typical High
$575.44
Medica
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$316.23
Typical High
$5,623.41
Medica
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$380.19
Typical High
$1,621.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$416.87
Typical High
$588.84
Midlands
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$3,548.13
Typical High
$3,548.13
Midlands
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$380.19
Typical High
$588.84
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$426.58
Typical High
$588.84
United
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$5,128.61
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$229.09
Typical High
$457.09
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$295.12
Typical High
$489.78