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Drainage of an Abscess Near the Tonsil

New Jersey 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?

$4,761

Typical total for the visit. In New Jersey, July 2026.

Insurers have agreed to pay about $4,761 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $4,571 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$191$145 to $257
Facility feeThe hospital or surgery center$4,571$2,291 to $6,918

How much rates vary

Facilitymedian $4,571 · 10th to 90th $380 to $10,965Professionalmedian $191 · 10th to 90th $126 to $468
$100$500$2K$10Kfacility $4,571professional $191

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
$380.19
Median
$4,677.35
Typical High
$10,471.29
Aetna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$186.21
Typical High
$707.95
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$354.81
Typical High
$354.81
AmeriHealth
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$21,379.62
Typical High
$32,359.37
Cigna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$218.78
Typical High
$478.63
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$204.17
Median
$281.84
Typical High
$407.38
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$478.63
Median
$776.25
Typical High
$1,174.90
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$204.17
Typical High
$407.38
United
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$2,691.53
Typical High
$6,760.83
United
Setting
Professional
Modifier
Global
Typical Low
$107.15
Median
$181.97
Typical High
$371.54

Where New Jersey 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

New Jersey· 2nd of 51

$4,761

$191 physician + $4,571 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.