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Drainage of an Abscess Near the Tonsil

New York 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?

$3,098

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

Insurers have agreed to pay about $3,098 for this procedure. That total is two separate charges: $214 to the doctor who performs it, and $2,884 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 11 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$214$174 to $302
Facility feeThe hospital or surgery center$2,884$871 to $4,467

How much rates vary

Facilitymedian $2,884 · 10th to 90th $214 to $7,244Professionalmedian $214 · 10th to 90th $135 to $501
$100$200$500$1K$2K$5K$10Kfacility $2,884professional $214

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
$2,041.74
Typical High
$7,585.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$190.55
Typical High
$416.87
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$117.49
Median
$123.03
Typical High
$199.53
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$3,630.78
Typical High
$5,011.87
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$204.17
Typical High
$371.54
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$190.55
Median
$1,258.93
Typical High
$4,073.80
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$190.55
Typical High
$275.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$223.87
Median
$223.87
Typical High
$1,318.26
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$257.04
Typical High
$645.65
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$186.21
Typical High
$501.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$295.12
Typical High
$436.52
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$177.83
Typical High
$177.83
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$194.98
Typical High
$398.11
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$295.12
Median
$407.38
Typical High
$1,479.11
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$141.25
Median
$50,118.72
Typical High
$75,857.76
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$218.78
Median
$338.84
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$2,344.23
Typical High
$4,897.79
United
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$295.12
Typical High
$912.01
Univera
Setting
Facility
Modifier
Global
Typical Low
$112.20
Median
$162.18
Typical High
$537.03
Univera
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$229.09
Typical High
$407.38

Where New York 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 York· 6th of 51

$3,098

$214 physician + $2,884 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.