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Biopsy of Upper Throat Behind the Nose

Indiana 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 $6,166 · 10th–90th $229$10,4710%10%10th90th$6,166Professionalmedian $191 · 10th–90th $112$3310%10%10th90th$191$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$134.90
Median
$1,862.09
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$346.74
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,187.76
Median
$8,317.64
Typical High
$10,471.29
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$158.49
Typical High
$251.19
CareSource
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$123.03
Typical High
$141.25
CareSource
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$104.71
Typical High
$104.71
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$398.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$363.08
United
Setting
Facility
Modifier
Global
Typical Low
$891.25
Median
$3,715.35
Typical High
$6,456.54
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$177.83
Typical High
$288.40