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Drainage of an Abscess Near the Tonsil

Montana 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?

$449

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

Insurers have agreed to pay about $449 for this procedure. That total is two separate charges: $186 to the doctor who performs it, and $263 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$141 to $251
Facility feeThe hospital or surgery center$263$234 to $339

How much rates vary

Facilitymedian $263 · 10th to 90th $178 to $457Professionalmedian $186 · 10th to 90th $132 to $398
$200$1K$5K$20Kfacility $263professional $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
$398.11
Median
$457.09
Typical High
$512.86
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$177.83
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$218.78
Median
$218.78
Typical High
$218.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$229.09
Typical High
$575.44
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$323.59
Typical High
$363.08
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$323.59
Typical High
$363.08
Providence
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$416.87
Providence
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$281.84
Typical High
$489.78
United
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$251.19
Typical High
$251.19
United
Setting
Professional
Modifier
Global
Typical Low
$186.21
Median
$263.03
Typical High
$380.19

Where Montana 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

Montana· 49th of 51

$449

$186 physician + $263 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.