go back

Biopsy of Upper Throat Behind the Nose

Massachusetts 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 $1,820 · 10th–90th $148$4,6770%5%10%10th90th$1,820Professionalmedian $219 · 10th–90th $117$5130%10%10th90th$219$100.0$500.0$2.0K$10.0K$50.0K

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
$2,238.72
Typical High
$3,801.89
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$407.38
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$3,630.78
Typical High
$19,498.45
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$251.19
Typical High
$1,548.82
BCBS
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$338.84
BCBS
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$457.09
Typical High
$1,659.59
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$478.63
Typical High
$3,090.30
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$251.19
Typical High
$524.81
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$302.00
Typical High
$436.52
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$3,162.28
Typical High
$8,511.38
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$263.03
Typical High
$537.03
Health New England
Setting
Facility
Modifier
Global
Typical Low
$6,165.95
Median
$6,165.95
Typical High
$6,165.95
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$316.23
Median
$3,630.78
Typical High
$19,498.45
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$251.19
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,951.21
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$263.03
Typical High
$549.54