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Drainage of an Abscess Near the Tonsil

New Mexico 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?

$448

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

Insurers have agreed to pay about $448 for this procedure. That total is two separate charges: $191 to the doctor who performs it, and $257 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$148 to $234
Facility feeThe hospital or surgery center$257$195 to $437

How much rates vary

Facilitymedian $257 · 10th to 90th $151 to $1,259Professionalmedian $191 · 10th to 90th $132 to $589
$50$100$200$500$1K$2Kfacility $257professional $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
$194.98
Median
$354.81
Typical High
$1,047.13
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$758.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$123.03
BCBS
Setting
Facility
Modifier
Global
Typical Low
$346.74
Median
$1,230.27
Typical High
$1,995.26
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$199.53
Typical High
$251.19
Cigna
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Cigna
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$213.80
Typical High
$331.13
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$269.15
Providence
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$208.93
Typical High
$363.08
Providence
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$234.42
Typical High
$389.05
United
Setting
Facility
Modifier
Global
Typical Low
$199.53
Median
$1,023.29
Typical High
$1,380.38
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$218.78
Typical High
$338.84

Where New Mexico 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 Mexico· 50th of 51

$448

$191 physician + $257 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.