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Biopsy of Upper Throat Behind the Nose

Kentucky 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 $1,950 · 10th–90th $257$3,3880%5%10%10th90th$1,950Professionalmedian $158 · 10th–90th $95$2690%10%10th90th$158$50.0$100.0$200.0$500.0$1.0K$2.0K$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
$147.91
Median
$851.14
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$169.82
Typical High
$269.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,148.15
Median
$2,137.96
Typical High
$2,951.21
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$144.54
Typical High
$213.80
CareSource
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$128.82
Typical High
$177.83
CareSource
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$131.83
Typical High
$177.83
Cigna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$194.98
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$1,047.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$213.80
United
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$2,089.30
Typical High
$4,168.69
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$181.97
Typical High
$302.00