go back

Biopsy of Upper Throat Behind the Nose

New Jersey 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.

Facilitymedian $5,888 · 10th–90th $372$10,7150%10%10th90th$5,888Professionalmedian $200 · 10th–90th $107$4070%10%10th90th$200$100.0$500.0$2.0K$10.0K

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
Facility
Modifier
Global
Typical Low
$281.84
Median
$5,888.44
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$186.21
Typical High
$346.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$213.80
Typical High
$478.63
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$302.00
Typical High
$446.68
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,760.83
Median
$10,471.29
Typical High
$16,595.87
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$208.93
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$4,897.79
Typical High
$8,511.38
United
Setting
Professional
Modifier
Global
Typical Low
$93.33
Median
$181.97
Typical High
$380.19