go back

Drainage of an Abscess Near the Tonsil

Massachusetts 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?

$965

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

Insurers have agreed to pay about $965 for this procedure. That total is two separate charges: $224 to the doctor who performs it, and $741 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$224$162 to $372
Facility feeThe hospital or surgery center$741$204 to $2,239

How much rates vary

Facilitymedian $741 · 10th to 90th $166 to $3,388Professionalmedian $224 · 10th to 90th $135 to $562
$100$200$500$1K$2K$5K$10Kfacility $741professional $224

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
$199.53
Median
$1,819.70
Typical High
$3,715.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$194.98
Typical High
$741.31
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$724.44
Typical High
$19,498.45
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$245.47
Typical High
$1,380.38
BCBS
Setting
Facility
Modifier
Global
Typical Low
$165.96
Median
$165.96
Typical High
$371.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$281.84
Typical High
$467.74
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$446.68
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$251.19
Typical High
$512.86
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$3,311.31
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$269.15
Typical High
$407.38
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$1,819.70
Typical High
$3,467.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$263.03
Typical High
$501.19
Health New England
Setting
Facility
Modifier
Global
Typical Low
$269.15
Median
$281.84
Typical High
$676.08
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$724.44
Typical High
$19,498.45
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$245.47
Typical High
$1,380.38
United
Setting
Facility
Modifier
Global
Typical Low
$309.03
Median
$954.99
Typical High
$2,754.23
United
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$269.15
Typical High
$524.81

Where Massachusetts 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

Massachusetts· 28th of 51

$965

$224 physician + $741 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.