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Drainage of an Abscess Near the Tonsil

Delaware 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?

$5,194

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

Insurers have agreed to pay about $5,194 for this procedure. That total is two separate charges: $182 to the doctor who performs it, and $5,012 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 4 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$182$141 to $219
Facility feeThe hospital or surgery center$5,012$4,786 to $5,623

How much rates vary

Facilitymedian $5,012 · 10th to 90th $1,413 to $5,623Professionalmedian $182 · 10th to 90th $132 to $309
$100$200$500$1K$2K$5Kfacility $5,012professional $182

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
$4,786.30
Median
$5,011.87
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$181.97
Typical High
$302.00
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$1,412.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$199.53
Typical High
$346.74
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$1,202.26
Typical High
$5,623.41
Highmark BCBS
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$199.53
United
Setting
Facility
Modifier
Global
Typical Low
$104.71
Median
$141.25
Typical High
$501.19
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$173.78
Typical High
$275.42

Where Delaware 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

Delaware· 1st of 51

$5,194

$182 physician + $5,012 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.