go back

Biopsy of Upper Throat Behind the Nose

Montana 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 $257 · 10th–90th $158$4170%20%10th90th$257Professionalmedian $200 · 10th–90th $112$3800%20%10th90th$200$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$112.20
Median
$199.53
Typical High
$371.54
BCBS
Setting
Facility
Modifier
Global
Typical Low
$46,773.51
Median
$75,857.76
Typical High
$95,499.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$223.87
Typical High
$512.86
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$331.13
Typical High
$398.11
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$199.53
Median
$331.13
Typical High
$398.11
Providence
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$239.88
Typical High
$426.58
Providence
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$288.40
Typical High
$549.54
United
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$269.15
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$245.47
Typical High
$389.05