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Drainage of an Abscess Near the Tonsil

Colorado rates for HCPCS 42700

This procedure drains a pocket of infection that has formed in the tissue next to a tonsil, a condition that can cause severe throat pain, difficulty swallowing, and a muffled voice. The clinician makes a small opening to release the pus and relieve pressure in the area.

Rates data updated July 2026.

How much does Drainage of an Abscess Near the Tonsil cost?

$1,003

Typical total for the visit. In Colorado, July 2026.

Insurers have agreed to pay about $1,003 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $813 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

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.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$191$148 to $240
Facility feeThe hospital or surgery center$813$240 to $3,388

How much rates vary

Facilitymedian $813 · 10th to 90th $178 to $5,623Professionalmedian $191 · 10th to 90th $132 to $355
$200$500$1K$2K$5K$10Kfacility $813professional $191

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
$199.53
Median
$1,202.26
Typical High
$6,025.60
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$354.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,454.71
Median
$3,388.44
Typical High
$8,511.38
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$229.09
Typical High
$354.81
Cigna
Setting
Facility
Modifier
Global
Typical Low
$602.56
Median
$891.25
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$354.81
Denver HMP
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$213.80
Typical High
$346.74
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$204.17
Typical High
$1,122.02
Select Health
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$263.03
Typical High
$436.52
Select Health
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$151.36
Typical High
$208.93
United
Setting
Facility
Modifier
Global
Typical Low
$501.19
Median
$1,202.26
Typical High
$2,691.53
United
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$218.78
Typical High
$363.08

Where Colorado sits

The same service costs 15.2 times more in Delaware than in Maryland. 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.

Physician feeFacility fee

Colorado· 27th of 51

$1,003

$191 physician + $813 facility

DE $5,194MD $341

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.