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Limited Removal Of Part Of The Throat

Ohio rates for HCPCS 42890

Removes a limited portion of the pharynx — the muscular tube behind the mouth and nose that carries food down to the swallowing tube — usually to take out a growth along with a rim of healthy tissue around it. Only part of the pharynx is taken and the remaining tissue is closed. Swallowing is retrained afterwards as the area heals.

Rates data updated July 2026.

How much does Limited Removal Of Part Of The Throat cost?

$7,413

Typical facility fee. In Ohio, July 2026.

Insurers have agreed to pay about $7,413 for this service. Most negotiated rates run $3,715 to $10,715.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $7,413 · 10th to 90th $1,738 to $12,882
$10$100$1K$10Kfacility $7,413

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$8,912.51
Typical High
$12,589.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$4,168.69
Typical High
$16,982.44
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,318.26
Median
$1,479.11
Typical High
$3,630.78
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$2,187.76
Typical High
$4,897.79
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$1,096.48
Median
$2,344.23
Typical High
$4,897.79
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$5,754.40
Typical High
$11,748.98

Where Ohio sits

The same service costs 11.7 times more in Maine than in West Virginia. 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.

Ohio· 8th of 50

$7,413

ME $16,218WV $1,380

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.