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Drainage of an Abscess Near the Tonsil

Maryland 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?

$341

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

Insurers have agreed to pay about $341 for this procedure. That total is two separate charges: $186 to the doctor who performs it, and $155 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$186$145 to $234
Facility feeThe hospital or surgery center$155$117 to $525

How much rates vary

Facilitymedian $155 · 10th to 90th $74 to $3,631Professionalmedian $186 · 10th to 90th $132 to $417
$100$200$500$1K$2Kfacility $155professional $186

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
$74.13
Median
$154.88
Typical High
$3,630.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$467.74
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$131.83
Typical High
$194.98
Cigna
Setting
Facility
Modifier
Global
Typical Low
$117.49
Median
$134.90
Typical High
$436.52
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$371.54
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$316.23
United
Setting
Facility
Modifier
Global
Typical Low
$75.86
Median
$112.20
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$194.98
Typical High
$346.74
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$213.80
Typical High
$309.03

Where Maryland 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

Maryland· 51st of 51

$341

$186 physician + $155 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.