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Biopsy of Upper Throat Behind the Nose

Maine 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 $457 · 10th–90th $457$6,7610%20%40%90th$457Professionalmedian $229 · 10th–90th $129$4790%10%10th90th$229$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$177.83
Typical High
$251.19
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$213.80
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$239.88
Typical High
$512.86
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$269.15
Typical High
$549.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$199.53
Typical High
$275.42
United
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$6,760.83
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$245.47
Typical High
$446.68