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Biopsy of Upper Throat Behind the Nose

Washington 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 $389 · 10th–90th $166$8,5110%10%10th90th$389Professionalmedian $219 · 10th–90th $117$5130%10%20%10th90th$219$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
$239.88
Median
$1,737.80
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$204.17
Typical High
$501.19
Asuris Northwest Health
Setting
Facility
Modifier
Global
Typical Low
$5,495.41
Median
$8,511.38
Typical High
$17,378.01
Asuris Northwest Health
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$302.00
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$204.17
Median
$501.19
Typical High
$3,311.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$263.03
Typical High
$562.34
Kaiser Permanente
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$295.12
Typical High
$2,818.38
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$269.15
Typical High
$562.34
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$81.28
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$380.19
Typical High
$436.52
Premera BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$295.12
Typical High
$1,862.09
Premera BCBS
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$295.12
Typical High
$537.03
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$5,888.44
Median
$8,912.51
Typical High
$17,378.01
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$316.23
Typical High
$467.74
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$9,549.93
Typical High
$18,620.87
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$239.88
Typical High
$416.87
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$223.87
Typical High
$316.23