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Drainage of an Abscess Near the Tonsil

Maine 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?

$846

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

Insurers have agreed to pay about $846 for this procedure. That total is two separate charges: $229 to the doctor who performs it, and $617 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$229$166 to $302
Facility feeThe hospital or surgery center$617$589 to $17,783

How much rates vary

Facilitymedian $617 · 10th to 90th $589 to $28,184Professionalmedian $229 · 10th to 90th $145 to $447
$1$10$100$1K$10Kfacility $617professional $229

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
$588.84
Median
$17,782.79
Typical High
$28,183.83
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$190.55
Typical High
$269.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$223.87
Typical High
$389.05
Cigna
Setting
Facility
Modifier
Global
Typical Low
$457.09
Median
$457.09
Typical High
$457.09
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$457.09
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$281.84
Typical High
$524.81
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$588.84
Median
$616.60
Typical High
$28,183.83
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$199.53
Typical High
$354.81
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$245.47
Typical High
$436.52

Where Maine 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

Maine· 32nd of 51

$846

$229 physician + $617 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.