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Biopsy of Upper Throat Behind the Nose

New Mexico 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 $263 · 10th–90th $129$6,1660%5%10th90th$263Professionalmedian $195 · 10th–90th $115$3310%10%10th90th$195$50.0$200.0$1.0K$5.0K

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
$173.78
Median
$331.13
Typical High
$2,137.96
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$194.98
Typical High
$331.13
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$6,165.95
Typical High
$9,772.37
BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$181.97
Typical High
$257.04
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$213.80
Typical High
$338.84
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$302.00
Providence
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$218.78
Typical High
$346.74
Providence
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$234.42
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$758.58
Median
$3,630.78
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$213.80
Typical High
$354.81