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Biopsy of Upper Throat Behind the Nose

Oklahoma 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?

$2,874

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

Insurers have agreed to pay about $2,874 for this procedure. That total is two separate charges: $182 to the doctor who performs it, and $2,692 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 5 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$182$126 to $224
Facility feeThe hospital or surgery center$2,692$759 to $4,898

How much rates vary

Facilitymedian $2,692 · 10th to 90th $209 to $7,079Professionalmedian $182 · 10th to 90th $112 to $302
$100$200$500$1K$2K$5K$10Kfacility $2,692professional $182

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
$223.87
Median
$1,380.38
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$173.78
Typical High
$269.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$4,897.79
Typical High
$8,317.64
BCBS
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$151.36
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$194.98
Typical High
$288.40
Medica
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$2,754.23
Medica
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$245.47
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$2,089.30
Typical High
$5,370.32
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$173.78
Typical High
$275.42

Where Oklahoma 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

Oklahoma· 16th of 50

$2,874

$182 physician + $2,692 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.