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Biopsy of Upper Throat Behind the Nose

Rhode Island 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 $2,570 · 10th–90th $832$5,4950%10%10th90th$2,570Professionalmedian $186 · 10th–90th $117$2950%10%20%10th90th$186$100.0$200.0$500.0$1.0K$2.0K$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
$1,513.56
Median
$1,548.82
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$186.21
Typical High
$257.04
BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$245.47
Typical High
$363.08
Cigna
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$2,570.40
Typical High
$2,570.40
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$478.63
United
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,467.37
Typical High
$6,165.95
United
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$190.55
Typical High
$323.59