Price Checker / CPT 42806
How much does Biopsy Of Upper Nose/throat cost?
CPT 42806 · Based on 2026 Medicare rates and hospital-published pricing
A fair cash price for this is roughly $360–$720.
Fair price
$360–$720
What this should cost
With insurance
~$2,850
Typical out-of-pocket
Overcharged if over
$900
Push back above this
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Biopsy Of Upper Nose/throat
CPT code 42806 refers to biopsy of upper nose/throat (billing description: "Biopsy of upper nose/throat"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $129 in a facility (hospital or surgery center) and $240 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.