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Biopsy of Upper Throat Behind the Nose

Texas 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 $1,380 · 10th–90th $148$6,4570%5%10th90th$1,380Professionalmedian $195 · 10th–90th $115$3240%20%10th90th$195$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$575.44
Median
$2,454.71
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$199.53
Typical High
$316.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$229.09
Typical High
$229.09
BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$3,981.07
Typical High
$7,762.47
BCBS
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$190.55
Typical High
$288.40
Christus
Setting
Facility
Modifier
Global
Typical Low
$109.65
Median
$2,691.53
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$1,659.59
Typical High
$1,949.84
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$213.80
Typical High
$398.11
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
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$223.87
Typical High
$588.84
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$204.17
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$181.97
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$426.58
Typical High
$588.84
Providence
Setting
Facility
Modifier
Global
Typical Low
$120.23
Median
$218.78
Typical High
$389.05
Providence
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$218.78
Typical High
$426.58
United
Setting
Facility
Modifier
Global
Typical Low
$724.44
Median
$2,187.76
Typical High
$4,365.16
United
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$173.78
Typical High
$295.12
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$204.17
Typical High
$234.42