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Creating a Feeding Opening Into the Throat

Ohio rates for HCPCS 42955

Makes an opening from the throat out through the skin of the neck so a feeding tube can be passed directly into the swallowing passage. It is used when a person cannot swallow safely or when the mouth and throat need to be bypassed, for instance after major surgery or injury in that area. The opening can be closed later if normal swallowing returns.

Rates data updated July 2026.

How much does Creating a Feeding Opening Into the Throat cost?

$851

Typical negotiated rate. In Ohio, July 2026.

Insurers have agreed to pay about $851 for this service. The price depends on where it is billed: about $813 from a physician practice, and about $3,162 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$813$724 to $1,000
FacilityA hospital or hospital-owned outpatient department$3,162$1,995 to $5,248

How much rates vary

Facilitymedian $3,162 · 10th to 90th $955 to $10,715Professionalmedian $813 · 10th to 90th $631 to $1,413
$10.0$100.0$1.0K$10.0Kfacility $3,162professional $813

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
$1,412.54
Median
$3,715.35
Typical High
$12,022.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$812.83
Typical High
$2,089.30
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$954.99
Median
$2,511.89
Typical High
$7,943.28
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$616.60
Median
$794.33
Typical High
$1,258.93
CareSource
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$794.33
Typical High
$912.01
CareSource
Setting
Professional
Modifier
Global
Typical Low
$776.25
Median
$776.25
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$954.99
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$537.03
Median
$933.25
Typical High
$1,621.81
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$954.99
Typical High
$1,258.93
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$933.25
Typical High
$1,548.82
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$2,398.83
Median
$2,398.83
Typical High
$2,398.83
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$691.83
Median
$812.83
Typical High
$1,548.82
United
Setting
Facility
Modifier
Global
Typical Low
$691.83
Median
$2,137.96
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$588.84
Median
$831.76
Typical High
$1,412.54

Where Ohio sits

The same service costs 2.8 times more in California than in West Virginia. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Ohio $851 · 40th of 51
CA $2,042WV $741

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.