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Biopsy of Upper Throat Behind the Nose

Minnesota 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?

$1,063

Typical total for the visit. In Minnesota, July 2026.

Insurers have agreed to pay about $1,063 for this procedure. That total is two separate charges: $355 to the doctor who performs it, and $708 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$355$224 to $513
Facility feeThe hospital or surgery center$708$309 to $1,778

How much rates vary

Facilitymedian $708 · 10th to 90th $158 to $7,762Professionalmedian $355 · 10th to 90th $148 to $776
$100$500$2K$10Kfacility $708professional $355

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
Facility
Modifier
Global
Typical Low
$117.49
Median
$213.80
Typical High
$213.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$346.74
BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$5,888.44
Typical High
$14,791.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$426.58
Typical High
$776.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$794.33
Typical High
$2,137.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$457.09
Typical High
$870.96
Health Partners
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$776.25
Typical High
$1,698.24
Health Partners
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$467.74
Typical High
$851.14
Medica
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$251.19
Typical High
$616.60
Medica
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$407.38
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$3,467.37
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$288.40
Typical High
$630.96

Where Minnesota sits

The same service costs 17.1 times more in Indiana than in West Virginia. 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.

Physician feeFacility fee

Minnesota· 36th of 50

$1,063

$355 physician + $708 facility

IN $6,340WV $370

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.