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Drainage of an Abscess Near the Tonsil

Ohio 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?

$1,727

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

Insurers have agreed to pay about $1,727 for this procedure. That total is two separate charges: $178 to the doctor who performs it, and $1,549 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 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$178$141 to $224
Facility feeThe hospital or surgery center$1,549$513 to $3,162

How much rates vary

Facilitymedian $1,549 · 10th to 90th $209 to $8,913Professionalmedian $178 · 10th to 90th $126 to $295
$100$200$500$1K$2K$5K$10Kfacility $1,549professional $178

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
$208.93
Median
$1,698.24
Typical High
$9,549.93
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$186.21
Typical High
$302.00
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$131.83
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$707.95
Median
$1,778.28
Typical High
$3,981.07
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$165.96
Typical High
$263.03
CareSource
Setting
Facility
Modifier
Global
Typical Low
$128.82
Median
$144.54
Typical High
$165.96
CareSource
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$141.25
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$501.19
Cigna
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$213.80
Typical High
$380.19
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$363.08
Typical High
$501.19
Medical Mutual of Ohio
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$218.78
Typical High
$371.54
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$93.33
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$181.97
Typical High
$181.97
SummaCare
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$194.98
Typical High
$338.84
United
Setting
Facility
Modifier
Global
Typical Low
$177.83
Median
$562.34
Typical High
$2,290.87
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$186.21
Typical High
$309.03

Where Ohio 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

Ohio· 14th of 51

$1,727

$178 physician + $1,549 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.