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Biopsy of Upper Throat Behind the Nose

Kansas 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 $2,692 · 10th–90th $174$7,5860%5%10th90th$2,692Professionalmedian $204 · 10th–90th $120$3090%10%10th90th$204$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
$263.03
Median
$3,630.78
Typical High
$8,128.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$363.08
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,890.45
Median
$4,073.80
Typical High
$4,073.80
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$602.56
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$389.05
Medica
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$223.87
Typical High
$2,454.71
Medica
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$302.00
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$2,454.71
Typical High
$3,981.07
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$302.00