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Biopsy of Upper Throat Behind the Nose

South Dakota 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.

Facilitymedian $214 · 10th–90th $117$2,2910%10%10th90th$214Professionalmedian $209 · 10th–90th $115$3980%10%10th90th$209$50.0$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
$117.49
Median
$213.80
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
Global
Typical Low
$112.20
Median
$190.55
Typical High
$263.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$363.08
Typical High
$645.65
Medica
Setting
Facility
Modifier
Global
Typical Low
$107.15
Median
$234.42
Typical High
$512.86
Medica
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$331.13
Typical High
$1,621.81
Midlands
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$309.03
Typical High
$457.09
Midlands
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$239.88
Typical High
$407.38
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$269.15
Typical High
$416.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$245.47
Typical High
$478.63
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$239.88
Median
$295.12
Typical High
$501.19