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Biopsy of Upper Throat Behind the Nose

North Dakota 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?

$439

Typical total for the visit. In North Dakota, July 2026.

Insurers have agreed to pay about $439 for this procedure. That total is two separate charges: $240 to the doctor who performs it, and $200 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$240$186 to $372
Facility feeThe hospital or surgery center$200$117 to $309

How much rates vary

Facilitymedian $200 · 10th to 90th $115 to $1,995Professionalmedian $240 · 10th to 90th $115 to $501
$100$200$500$1K$2K$5Kfacility $200professional $240

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
$114.82
Median
$199.53
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$186.21
Typical High
$346.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$346.74
Typical High
$549.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$309.03
Typical High
$588.84
Medica
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$213.80
Typical High
$416.87
Medica
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$338.84
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$2,398.83
Typical High
$6,606.93
United
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$218.78
Typical High
$416.87

Where North Dakota 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

North Dakota· 49th of 50

$439

$240 physician + $200 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.