Removal of Part of the Throat Wall With Flap Repair

Nationwide rates for HCPCS 42894

Removes a section of the wall of the throat and rebuilds the gap with a flap of the patient's own tissue, moved in with its blood supply so the passage stays open. It is done mainly for cancer involving the throat wall. The tissue removed is examined afterwards.

Rates data updated July 2026.

How much does Removal of Part of the Throat Wall With Flap Repair cost?

$8,586

Typical total for the visit. Nationwide, July 2026.

Insurers have agreed to pay about $8,586 for this procedure. That total is two separate charges: $3,090 to the doctor who performs it, and $5,495 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

36% physician fee64% facility fee

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 52 insurance carriers under federal price transparency rules.

What's inside this number

Part of the bill	Who charges it	Typical	Range
Physician feeThe doctor who performs it	The doctor who performs it	$3,090	$2,239 to $4,786
Facility feeThe hospital or surgery center	The hospital or surgery center	$5,495	$2,818 to $10,715

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,950 to $16,218Professionalmedian $3,090 · 10th to 90th $1,995 to $9,120

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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier Global Typical Low $1,659.59 Median $4,466.84 Typical High $11,748.98	Facility	Global	$1,659.59	$4,466.84	$11,748.98
BCBS Setting Facility Modifier Global Typical Low $3,715.35 Median $10,471.29 Typical High $20,892.96	Facility	Global	$3,715.35	$10,471.29	$20,892.96
Cigna Setting Facility Modifier Global Typical Low $501.19 Median $3,630.78 Typical High $12,589.25	Facility	Global	$501.19	$3,630.78	$12,589.25
United Setting Facility Modifier Global Typical Low $575.44 Median $2,818.38 Typical High $9,549.93	Facility	Global	$575.44	$2,818.38	$9,549.93

What it costs in each state

The same service costs 4.9 times more in Wisconsin than in Maryland. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Physician feeFacility fee

WI $14,018MD $2,835

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.