Biopsy Of Tissue At The Back Of The Mouth And Throat
Wyoming rates for HCPCS 42800
This procedure takes a small tissue sample from the area at the back of the mouth and upper throat, including the tonsils and soft palate region, to be examined under a microscope. It's used to investigate a visible sore, growth, or other abnormality in this area. It's typically a quick procedure done under local or general anesthesia depending on the situation.
Rates data updated July 2026.
How much does Biopsy Of Tissue At The Back Of The Mouth And Throat cost?
$182
Typical physician fee. In Wyoming, July 2026.
Insurers have agreed to pay about $182 for this service. Most negotiated rates run $148 to $479.
These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 4 insurance carriers under federal price transparency rules.
How much rates vary
Facilitymedian $3,162 · 10th to 90th $794 to $3,311Professionalmedian $182 · 10th to 90th $110 to $575
Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
Insurance Carrier
Facility/Professional
Modifier
Typical LowTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
MedianTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Typical HighTypical Low is the 10th percentile of the published rates, Median the 50th, and Typical High the 90th. One in ten rates falls below Typical Low, and one in ten falls above Typical High.
Aetna
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$229.09
Professional
Global
$109.65
$151.36
$229.09
BCBS
Setting
Professional
Modifier
Global
Typical Low
$371.54
Median
$478.63
Typical High
$645.65
Professional
Global
$371.54
$478.63
$645.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$218.78
Typical High
$407.38
Professional
Global
$131.83
$218.78
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$794.33
Median
$3,162.28
Typical High
$3,311.31
Facility
Global
$794.33
$3,162.28
$3,311.31
United
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$223.87
Typical High
$446.68
Professional
Global
$134.90
$223.87
$446.68
Where Wyoming sits
The same service costs 2.1 times more in Minnesota than in Hawaii. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.