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Biopsy of Upper Throat Behind the Nose

Nevada 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?

$1,884

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

Insurers have agreed to pay about $1,884 for this procedure. That total is two separate charges: $186 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$186$129 to $229
Facility feeThe hospital or surgery center$1,698$229 to $3,890

How much rates vary

Facilitymedian $1,698 · 10th to 90th $129 to $5,248Professionalmedian $186 · 10th to 90th $112 to $316
$100$200$500$1K$2K$5K$10Kfacility $1,698professional $186

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
$128.82
Median
$1,698.24
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$302.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,801.89
Median
$4,073.80
Typical High
$5,888.44
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$371.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$1,479.11
Typical High
$2,041.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$346.74
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$169.82
Typical High
$302.00
Hometown Health
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$1,548.82
Typical High
$1,548.82
Hometown Health
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$169.82
Typical High
$323.59
Select Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$194.98
Typical High
$213.80
Select Health
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$107.15
Typical High
$223.87
United
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$1,548.82
Typical High
$3,630.78
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$186.21
Typical High
$331.13

Where Nevada 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

Nevada· 25th of 50

$1,884

$186 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.