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Biopsy of Upper Throat Behind the Nose

Maryland 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?

$178

Typical physician fee. In Maryland, July 2026.

Insurers have agreed to pay about $178 for this service. Most negotiated rates run $126 to $224.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $708 · 10th to 90th $398 to $1,622Professionalmedian $178 · 10th to 90th $112 to $309
$100$200$500$1K$2K$5Kfacility $708professional $178

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
Professional
Modifier
Global
Typical Low
$112.20
Median
$177.83
Typical High
$295.12
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$123.03
Typical High
$190.55
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,479.11
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$380.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$245.47
Typical High
$346.74
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$524.81
Typical High
$1,318.26
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$190.55
Typical High
$354.81
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$229.09
Typical High
$338.84

Where Maryland sits

The same service costs 2.2 times more in Minnesota than in Kentucky. 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.

Maryland· 49th of 51

$178

MN $363KY $166

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.