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Biopsy of Upper Throat Behind the Nose

West Virginia 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 $204 · 10th–90th $117$1,4130%20%10th90th$204Professionalmedian $166 · 10th–90th $107$2690%10%10th90th$166$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
Facility
Modifier
Global
Typical Low
$117.49
Median
$204.17
Typical High
$1,230.27
Aetna
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$165.96
Typical High
$263.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$151.36
CareSource
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
Cigna
Setting
Facility
Modifier
Global
Typical Low
$194.98
Median
$194.98
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$223.87
Typical High
$1,047.13
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$1,621.81
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$169.82
Typical High
$309.03