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Biopsy of Upper Throat Behind the Nose

Vermont 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.

Professionalmedian $200 · 10th–90th $123$2570%10%20%10th90th$200$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
Professional
Modifier
Global
Typical Low
$117.49
Median
$194.98
Typical High
$229.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$199.53
Typical High
$323.59
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$281.84
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$251.19
Typical High
$446.68