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Biopsy of Upper Throat Behind the Nose

Louisiana 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.

How much does Biopsy of Upper Throat Behind the Nose cost?

$1,704

Typical total for the visit. In Louisiana, July 2026.

Insurers have agreed to pay about $1,704 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $1,514 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$191$132 to $251
Facility feeThe hospital or surgery center$1,514$891 to $3,236

How much rates vary

Facilitymedian $1,514 · 10th to 90th $295 to $4,365Professionalmedian $191 · 10th to 90th $115 to $339
$100$200$500$1K$2K$5Kfacility $1,514professional $191

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$263.03
Median
$1,288.25
Typical High
$3,467.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$3,715.35
Typical High
$6,025.60
BCBS
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$229.09
Typical High
$338.84
Christus
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$2,691.53
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$537.03
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$223.87
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$1,698.24
Typical High
$5,011.87
United
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$177.83
Typical High
$302.00

Where Louisiana sits

The same service costs 17.1 times more in Indiana than in West Virginia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Louisiana· 29th of 50

$1,704

$191 physician + $1,514 facility

IN $6,340WV $370

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.