Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
BIOPSY OF UPPER NOSE/THROAT
Boulder, CO
See all hospitals reporting CPT 42804 →Price type
Boulder Community Health’s median price of $225 is 93% below the median hospital's median price ($3.2k), higher than 11% of the 1,643 hospitals reporting CPT 42804. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 27 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Aetna medicare advantage professional · case rate · both | $116 | $116 | — | — | — | $116 – $116 |
| 2 | Anthem medicare advantage professional · fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 3 | Devoted medicare advantage professional · fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 4 | Humana medicare advantage professional · fee schedule · both | $116 | $116 | — | — | — | $116 – $116 |
| 5 | Kaiser medicare advantage professional · fee schedule · both | $144 | $144 | — | — | — | $144 – $144 |
| 6 | Anthem commercial professional · fee schedule · both | $156 | $172 | $25 | 14% | — | $156 – $211 |
| 7 | Kaiser commercial professional · fee schedule · both | $184 | $184 | — | — | — | $184 – $184 |
| 8 | MultiPlan commercial professional · fee schedule · both | $194 | $194 | — | — | — | $194 – $194 |
| 9 | Phcs commercial professional · fee schedule · both | $194 | $194 | — | — | — | $194 – $194 |
| 10 | Cigna commercial facility · fee schedule · outpatient | $204 | $204 | — | — | — | $204 – $204 |
| 11 | Anthem managed care professional · fee schedule · both | $211 | $211 | — | — | — | $211 – $211 |
| 12 | Cigna commercial professional · fee schedule · both | $213 | $213 | — | — | — | $213 – $213 |
| 13 | Aetna commercial professional · fee schedule · both | $225 | $225 | — | — | — | $225 – $225 |
| 14 | Aetna ppo professional · fee schedule · both | $225 | $225 | — | — | — | $225 – $225 |
| 15 | UnitedHealthcare commercial professional · fee schedule · both | $227 | $227 | — | — | — | $227 – $227 |
| 16 | UnitedHealthcare medicare advantage professional · fee schedule · both | $1.8k | $1.8k | $1.7k | 94% | — | $116 – $3.5k |
| 17 | Aetna medicare advantage facility · case rate · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 18 | Anthem medicare advantage facility · case rate · outpatient | $3.5k | $3.5k | — | — | — | $3.5k – $3.5k |
| 19 | Humana medicare advantage facility · case rate · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 20 | UnitedHealthcare medicare advantage facility · case rate · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 21 | Kaiser medicare advantage facility · case rate · outpatient | $3.6k | $3.6k | $18 | 0% | — | $3.6k – $3.6k |
| 22 | Devoted medicare advantage facility · case rate · outpatient | $3.6k | $3.6k | — | — | — | $3.6k – $3.6k |
| 23 | UnitedHealthcare commercial facility · fee schedule · outpatient | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 24 | Kaiser commercial facility · case rate · outpatient | $7.7k | $7.7k | $934 | 12% | — | $6.8k – $8.6k |
| 25 | Kaiser managed care facility · case rate · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
Last updated: Sep 16, 2026
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