go back

Drainage of an Abscess Near the Tonsil

Michigan 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?

$575

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

Insurers have agreed to pay about $575 for this procedure. That total is two separate charges: $186 to the doctor who performs it, and $389 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 7 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 $229
Facility feeThe hospital or surgery center$389$240 to $1,096

How much rates vary

Facilitymedian $389 · 10th to 90th $174 to $4,677Professionalmedian $186 · 10th to 90th $132 to $288
$100$200$500$1K$2K$5Kfacility $389professional $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
$173.78
Median
$389.05
Typical High
$4,677.35
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$269.15
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$234.42
Typical High
$269.15
BCBS
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$295.12
Typical High
$295.12
BCBS
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$213.80
Typical High
$295.12
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$194.98
Typical High
$371.54
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$173.78
Median
$251.19
Typical High
$4,897.79
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$204.17
Typical High
$331.13
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$549.54
Typical High
$1,122.02
United
Setting
Facility
Modifier
Global
Typical Low
$186.21
Median
$660.69
Typical High
$1,737.80
United
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$204.17
Typical High
$302.00

Where Michigan 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

Michigan· 43rd of 51

$575

$186 physician + $389 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.