go back

Drainage of an Abscess Near the Tonsil

Washington, DC 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?

$191

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $191 for this service. Most negotiated rates run $151 to $224.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $1,413 · 10th to 90th $162 to $4,074Professionalmedian $174 · 10th to 90th $135 to $234
$100$200$500$1K$2K$5Kfacility $1,413professional $174

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
$162.18
Median
$1,584.89
Typical High
$4,073.80
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$162.18
Typical High
$234.42
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$144.54
Typical High
$851.14
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$524.81
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$229.09
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$549.54
Typical High
$1,548.82
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$398.11

Where Washington, DC sits

The same service costs 2.0 times more in Minnesota than in Kentucky. 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.

Washington, DC· 45th of 51

$191

MN $363KY $182

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.