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Biopsy of Upper Throat Behind the Nose

Ohio 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 $2,239 · 10th–90th $219$10,2330%5%10%10th90th$2,239Professionalmedian $170 · 10th–90th $112$3020%10%20%10th90th$170$1.0$5.0$20.0$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
$208.93
Median
$2,089.30
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$186.21
Typical High
$309.03
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,187.76
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$158.49
Typical High
$275.42
CareSource
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$128.82
Typical High
$1,737.80
CareSource
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$144.54
Cigna
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$363.08
Typical High
$2,398.83
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$204.17
Typical High
$398.11
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$398.11
Typical High
$2,398.83
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$208.93
Typical High
$380.19
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$63.10
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$5,128.61
Median
$5,128.61
Typical High
$5,128.61
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$208.93
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$2,570.40
Typical High
$6,025.60
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$177.83
Typical High
$309.03