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Drainage of an Abscess Near the Tonsil

Missouri 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?

$1,463

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

Insurers have agreed to pay about $1,463 for this procedure. That total is two separate charges: $204 to the doctor who performs it, and $1,259 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$204$155 to $302
Facility feeThe hospital or surgery center$1,259$302 to $2,512

How much rates vary

Facilitymedian $1,259 · 10th to 90th $186 to $4,266Professionalmedian $204 · 10th to 90th $132 to $794
$200$500$1K$2K$5Kfacility $1,259professional $204

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
$177.83
Median
$1,380.38
Typical High
$5,623.41
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$204.17
Typical High
$891.25
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$371.54
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$1,778.28
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$302.00
BCBS
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$208.93
Typical High
$288.40
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$1,659.59
Typical High
$1,659.59
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$213.80
Typical High
$363.08
Medica
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$223.87
Typical High
$724.44
Medica
Setting
Professional
Modifier
Global
Typical Low
$181.97
Median
$331.13
Typical High
$1,445.44
United
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$549.54
Typical High
$1,445.44
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$194.98
Typical High
$338.84

Where Missouri 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

Missouri· 19th of 51

$1,463

$204 physician + $1,259 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.