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Procedure price report · Diagnostic procedures on nose, mouth and pharynx

Biopsy of the back of the mouth and throat

CPT 42800the billing code this page is about

Removal of a small tissue sample from the oropharynx, the part of the throat just behind the mouth, for laboratory examination.

Hospitals typically charge $1,594 cash for this outpatient procedure — the median across 930 hospitals that filed a usable cash price; the average of the middle 60% is $1,616. Most fall between $302 and $3,490 (20th–80th percentile).

Hospitals
930
States
50
Filings dated
Aug 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 930 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$181$398$1,594$3,111$4,920

The most expensive tenth of hospitals charges at least 27× what the cheapest tenth charges ($181 vs $4,920).

How the prices are spread

$132 – $195: 76 hospitals$132$195 – $288: 66 hospitals$288 – $426: 65 hospitals$288$426 – $628: 67 hospitals$628 – $927: 50 hospitals$628$927 – $1,369: 67 hospitals$1,369 – $2,021: 145 hospitals$1,369$2,021 – $2,984: 103 hospitals$2,984 – $4,404: 138 hospitals$2,984$4,404 – $6,502: 76 hospitals$4,404median $1,594price bands are equal on a log scale
Hospitals per price band (853 of 930 — the bands cover the 5th to 95th percentile)
FromToHospitals
$132$19576
$195$28866
$288$42665
$426$62867
$628$92750
$927$1,36967
$1,369$2,021145
$2,021$2,984103
$2,984$4,404138
$4,404$6,50276

Against Medicare

Medicare pays (OPPS 2026, national rate)$1,585
Median cash price$1,594
Cash as a multiple of Medicare1.01×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $1,594.

Alaska: 6 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 5 hospitals filed a usable price — fewer than 10, so no figureMEVermont: 7 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 5 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $1,629 across 15 hospitalsWA$1,629Idaho: median $2,060 across 11 hospitalsID$2,060Montana: 7 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 5 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $429 across 25 hospitalsMN$429Illinois: median $919 across 42 hospitalsIL$919Wisconsin: median $857 across 50 hospitalsWI$857Michigan: median $1,546 across 50 hospitalsMI$1,546New York: median $1,753 across 51 hospitalsNY$1,753Massachusetts: median $2,380 across 12 hospitalsMA$2,380Oregon: median $1,919 across 27 hospitalsOR$1,919Nevada: 5 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 4 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 9 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $387 across 29 hospitalsIA$387Indiana: median $616 across 23 hospitalsIN$616Ohio: median $1,855 across 52 hospitalsOH$1,855Pennsylvania: median $1,737 across 34 hospitalsPA$1,737New Jersey: median $4,350 across 34 hospitalsNJ$4,350Connecticut: 6 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 1 hospital filed a usable price — fewer than 10, so no figureRICalifornia: median $3,884 across 58 hospitalsCA$3,884Utah: 1 hospital filed a usable price — fewer than 10, so no figureUTColorado: median $4,046 across 11 hospitalsCO$4,046Nebraska: median $367 across 19 hospitalsNE$367Missouri: median $1,204 across 26 hospitalsMO$1,204Kentucky: median $172 across 10 hospitalsKY$172West Virginia: median $654 across 15 hospitalsWV$654Virginia: median $2,284 across 17 hospitalsVA$2,284Maryland: 4 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 1 hospital filed a usable price — fewer than 10, so no figureDEArizona: 4 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 5 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $469 across 11 hospitalsKS$469Arkansas: 5 hospitals filed a usable price — fewer than 10, so no figureARTennessee: median $286 across 12 hospitalsTN$286North Carolina: median $1,870 across 26 hospitalsNC$1,870South Carolina: median $2,361 across 21 hospitalsSC$2,361Oklahoma: median $193 across 16 hospitalsOK$193Louisiana: median $1,267 across 19 hospitalsLA$1,267Mississippi: 9 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 6 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $1,311 across 19 hospitalsGA$1,311Hawaii: 7 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $3,047 across 56 hospitalsTX$3,047Florida: median $2,082 across 37 hospitalsFL$2,082
Cash price by state, most expensive first. National median $1,594. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
New Jersey NJ34$4,350+173%$1,641 – $5,419
Colorado CO11$4,046+154%$1,083 – $4,046
California CA58$3,884+144%$1,125 – $6,502
Texas TX56$3,047+91%$1,698 – $4,413
Massachusetts MA12$2,380+49%$1,289 – $3,414
South Carolina SC21$2,361+48%$2,361 – $3,111
Virginia VA17$2,284+43%$566 – $2,443
Florida FL37$2,082+31%$1,487 – $5,537
Idaho ID11$2,060+29%$1,119 – $4,054
Oregon OR27$1,919+20%$289 – $4,376
North Carolina NC26$1,870+17%$652 – $2,335
Ohio OH52$1,855+16%$420 – $3,186
New York NY51$1,753+10%$478 – $3,295
Pennsylvania PA34$1,737+9%$89 – $2,504
Washington WA15$1,629+2%$223 – $3,603
Michigan MI50$1,546−3%$132 – $3,164
Georgia GA19$1,311−18%$1,311 – $9,715
Louisiana LA19$1,267−21%$596 – $2,760
Missouri MO26$1,204−24%$239 – $2,526
Illinois IL42$919−42%$253 – $3,113
Wisconsin WI50$857−46%$283 – $2,372
West Virginia WV15$654−59%$123 – $1,888
Indiana IN23$616−61%$154 – $946
Kansas KS11$469−71%$265 – $1,040
Minnesota MN25$429−73%$160 – $503
Iowa IA29$387−76%$302 – $921
Nebraska NE19$367−77%$170 – $1,927
Tennessee TN12$286−82%$153 – $1,911
Oklahoma OK16$193−88%$193 – $3,020
Kentucky KY10$172−89%$154 – $248
Mississippi MS9not enough hospitals filed a usable price
South Dakota SD9not enough hospitals filed a usable price
Hawaii HI7not enough hospitals filed a usable price
Montana MT7not enough hospitals filed a usable price
Vermont VT7not enough hospitals filed a usable price
Alaska AK6not enough hospitals filed a usable price
Alabama AL6not enough hospitals filed a usable price
Connecticut CT6not enough hospitals filed a usable price
Arkansas AR5not enough hospitals filed a usable price
Maine ME5not enough hospitals filed a usable price
North Dakota ND5not enough hospitals filed a usable price
New Hampshire NH5not enough hospitals filed a usable price
New Mexico NM5not enough hospitals filed a usable price
Nevada NV5not enough hospitals filed a usable price
Arizona AZ4not enough hospitals filed a usable price
Maryland MD4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Delaware DE1not enough hospitals filed a usable price
Rhode Island RI1not enough hospitals filed a usable price
Utah UT1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $1,594.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care728$1,812$387 – $3,884
Children’s13fewer than 20 hospitals
Critical access186$476$218 – $1,912
Ownership
For-profit71$1,778$652 – $3,670
Government158$1,200$223 – $2,394
Non-profit698$1,641$317 – $3,543
System affiliation
Part of a system770$1,737$370 – $3,567
Independent160$694$229 – $2,502

Cash price vs list price

Median list price (chargemaster)$2,516
Median cash price$1,594
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

615 hospitals filed a usable inpatient cash price for this code. The median is $1,576 and the average of the middle 60% is $1,613; most fall between $287 and $3,239.

Cash price percentiles, inpatient, across 615 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$184$387$1,576$3,080$4,054

The most expensive tenth of hospitals charges at least 22× what the cheapest tenth charges ($184 vs $4,054).

Of the 658 hospitals that filed this code inpatient, 615 gave a usable cash price; 21 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 22 a list price only.

How complete is this

930 of the 3,956 hospitals with a price file in our corpus (24%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 1,021 hospitals that filed this code at all gave us
Usable cash price — counted930
Cash price carrying a plausibility flag — shown on the compare tool, excluded here58
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded0
A list price only, no cash figure — excluded33
Hospitals that filed this code1,021

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Diagnostic procedures on nose, mouth and pharynx family.

Hospitals file this code under descriptions such as Biopsy Oropharynx.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Biopsy of the back of the mouth and throat (CPT 42800) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-42800-biopsy-of-the-back-of-the-mouth-and-throat