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Drainage of an Abscess Near the Tonsil

Iowa 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?

$837

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

Insurers have agreed to pay about $837 for this procedure. That total is two separate charges: $234 to the doctor who performs it, and $603 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$234$174 to $417
Facility feeThe hospital or surgery center$603$309 to $2,951

How much rates vary

Facilitymedian $603 · 10th to 90th $209 to $6,457Professionalmedian $234 · 10th to 90th $135 to $891
$200$500$1K$2K$5K$10Kfacility $603professional $234

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
$323.59
Median
$2,570.40
Typical High
$7,943.28
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$229.09
Typical High
$891.25
Cigna
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$323.59
Typical High
$524.81
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$302.00
Typical High
$549.54
Medica
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$316.23
Typical High
$707.95
Medica
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$371.54
Typical High
$1,445.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$363.08
Typical High
$524.81
Midlands
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$309.03
Typical High
$309.03
Midlands
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$371.54
Typical High
$537.03
United
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$630.96
Typical High
$2,344.23
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$234.42
Typical High
$457.09
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$269.15
Median
$331.13
Typical High
$489.78

Where Iowa 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

Iowa· 33rd of 51

$837

$234 physician + $603 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.