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Drainage of an Abscess Near the Tonsil

Indiana 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?

$3,493

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

Insurers have agreed to pay about $3,493 for this procedure. That total is two separate charges: $182 to the doctor who performs it, and $3,311 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 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$182$138 to $219
Facility feeThe hospital or surgery center$3,311$316 to $4,898

How much rates vary

Facilitymedian $3,311 · 10th to 90th $204 to $8,318Professionalmedian $182 · 10th to 90th $126 to $324
$100$200$500$1K$2K$5K$10Kfacility $3,311professional $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
$165.96
Median
$478.63
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$186.21
Typical High
$323.59
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$190.55
Typical High
$354.81
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$3,890.45
Typical High
$8,317.64
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$162.18
Typical High
$245.47
CareSource
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$138.04
Typical High
$154.88
CareSource
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
Cigna
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$389.05
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$2,041.74
Typical High
$5,754.40
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$181.97
Typical High
$288.40

Where Indiana 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

Indiana· 5th of 51

$3,493

$182 physician + $3,311 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.