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Biopsy of Upper Throat Behind the Nose

Tennessee 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 $468$6,3100%5%10%10th90th$2,239Professionalmedian $195 · 10th–90th $115$3550%10%10th90th$195$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
$316.23
Median
$1,479.11
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$323.59
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,513.56
Median
$3,981.07
Typical High
$5,888.44
BCBS
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$371.54
Median
$1,659.59
Typical High
$3,019.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$363.08
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$19,498.45
Typical High
$19,498.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$1,819.70
Typical High
$1,819.70
United
Setting
Facility
Modifier
Global
Typical Low
$912.01
Median
$2,137.96
Typical High
$3,715.35
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$186.21
Typical High
$338.84