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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.

Facilitymedian $759 · 10th–90th $398$1,5140%10%10th90th$759Professionalmedian $200 · 10th–90th $115$3630%10%10th90th$200$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
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$371.54
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$131.83
Typical High
$239.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$1,318.26
Typical High
$1,862.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$389.05
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
$575.44
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$186.21
Typical High
$331.13
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$245.47
Typical High
$338.84