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Biopsy of Upper Throat Behind the Nose

Michigan 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 $2,042 · 10th–90th $269$4,8980%20%10th90th$2,042Professionalmedian $195 · 10th–90th $115$3240%10%10th90th$195$50.0$200.0$1.0K$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
Facility
Modifier
Global
Typical Low
$269.15
Median
$2,041.74
Typical High
$4,897.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$323.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$186.21
Typical High
$186.21
BCBS
Setting
Professional
Modifier
Global
Typical Low
$37.15
Median
$177.83
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$436.52
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$954.99
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$213.80
Typical High
$363.08
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$302.00
United
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$3,311.31
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$190.55
Typical High
$309.03