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Biopsy of Upper Throat Behind the Nose

New Hampshire 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?

$1,927

Typical total for the visit. In New Hampshire, July 2026.

Insurers have agreed to pay about $1,927 for this procedure. That total is two separate charges: $229 to the doctor who performs it, and $1,698 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$229$162 to $309
Facility feeThe hospital or surgery center$1,698$724 to $3,020

How much rates vary

Facilitymedian $1,698 · 10th to 90th $100 to $8,913Professionalmedian $229 · 10th to 90th $129 to $447
$20$100$500$2K$10Kfacility $1,698professional $229

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
$398.11
Median
$724.44
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$186.21
Typical High
$269.15
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$1,737.80
Typical High
$3,019.95
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$213.80
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,348.96
Median
$1,348.96
Typical High
$1,348.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$263.03
Typical High
$501.19
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$3,890.45
Typical High
$8,709.64
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$269.15
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$3,890.45
Typical High
$8,709.64
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$269.15
Typical High
$524.81
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$19.50
Median
$22.39
Typical High
$275.42

Where New Hampshire 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

New Hampshire· 24th of 50

$1,927

$229 physician + $1,698 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.