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Drainage of an Abscess Near the Tonsil

Idaho 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?

$537

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

Insurers have agreed to pay about $537 for this procedure. That total is two separate charges: $214 to the doctor who performs it, and $324 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 8 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$214$158 to $324
Facility feeThe hospital or surgery center$324$219 to $525

How much rates vary

Facilitymedian $324 · 10th to 90th $170 to $776Professionalmedian $214 · 10th to 90th $135 to $468
$200$500$1K$2K$5Kfacility $324professional $214

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
$309.03
Median
$630.96
Typical High
$4,466.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$199.53
Typical High
$562.34
BCBS
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$457.09
Typical High
$741.31
BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$281.84
Typical High
$380.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$229.09
Typical High
$346.74
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$234.42
Typical High
$457.09
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$213.80
Median
$269.15
Typical High
$389.05
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$181.97
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$588.84
Typical High
$794.33
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$288.40
Typical High
$389.05
Select Health
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$371.54
Typical High
$588.84
Select Health
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$181.97
Typical High
$257.04
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$8,317.64
Typical High
$9,332.54
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$363.08

Where Idaho 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

Idaho· 46th of 51

$537

$214 physician + $324 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.