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Biopsy of Upper Throat Behind the Nose

Nebraska 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?

$3,767

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

Insurers have agreed to pay about $3,767 for this procedure. That total is two separate charges: $219 to the doctor who performs it, and $3,548 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$219$132 to $339
Facility feeThe hospital or surgery center$3,548$347 to $7,762

How much rates vary

Facilitymedian $3,548 · 10th to 90th $174 to $13,490Professionalmedian $219 · 10th to 90th $117 to $537
$100$500$2K$10Kfacility $3,548professional $219

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
$2,187.76
Median
$6,025.60
Typical High
$14,454.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$208.93
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,548.13
Median
$4,677.35
Typical High
$9,120.11
BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$234.42
Typical High
$407.38
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$354.81
Typical High
$602.56
Medica
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$223.87
Typical High
$446.68
Medica
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$407.38
Typical High
$1,621.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$407.38
Typical High
$575.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$363.08
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$3,311.31
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$269.15
Typical High
$489.78

Where Nebraska 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

Nebraska· 8th of 50

$3,767

$219 physician + $3,548 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.