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Biopsy of Upper Throat Behind the Nose

Missouri 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?

$1,859

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

Insurers have agreed to pay about $1,859 for this procedure. That total is two separate charges: $200 to the doctor who performs it, and $1,660 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$200$132 to $257
Facility feeThe hospital or surgery center$1,660$617 to $3,020

How much rates vary

Facilitymedian $1,660 · 10th to 90th $200 to $5,012Professionalmedian $200 · 10th to 90th $115 to $407
$100$200$500$1K$2K$5K$10Kfacility $1,660professional $200

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
$199.53
Median
$2,398.83
Typical High
$6,309.57
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$199.53
Typical High
$630.96
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,819.70
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$181.97
Typical High
$316.23
BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$213.80
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$204.17
Typical High
$371.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$229.09
Typical High
$1,380.38
Medica
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$346.74
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$2,290.87
Typical High
$3,019.95
United
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$346.74

Where Missouri 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

Missouri· 27th of 50

$1,859

$200 physician + $1,660 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.