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Biopsy of Upper Throat Behind the Nose

Illinois 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 $1,380 · 10th–90th $204$5,3700%5%10th90th$1,380Professionalmedian $204 · 10th–90th $117$3800%10%10th90th$204$20.0$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
$204.17
Median
$1,258.93
Typical High
$5,370.32
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,202.26
Median
$4,073.80
Typical High
$5,623.41
BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$213.80
Typical High
$380.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$1,000.00
Typical High
$2,691.53
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$213.80
Typical High
$398.11
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$323.59
Typical High
$741.31
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$151.36
Typical High
$281.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$281.84
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$2,818.38
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$354.81