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Drainage of an Abscess Near the Tonsil

South Carolina 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?

$558

Typical total for the visit. In South Carolina, July 2026.

Insurers have agreed to pay about $558 for this procedure. That total is two separate charges: $195 to the doctor who performs it, and $363 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$195$158 to $251
Facility feeThe hospital or surgery center$363$209 to $1,148

How much rates vary

Facilitymedian $363 · 10th to 90th $162 to $5,754Professionalmedian $195 · 10th to 90th $132 to $417
$100$500$2K$10Kfacility $363professional $195

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
$1,148.15
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$199.53
Typical High
$426.58
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$275.42
Typical High
$275.42
BCBS
Setting
Facility
Modifier
Global
Typical Low
$407.38
Median
$776.25
Typical High
$1,412.54
BCBS
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$181.97
Typical High
$263.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$223.87
Typical High
$426.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$147.91
Median
$213.80
Typical High
$416.87
Medcost
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$251.19
Typical High
$263.03
Medcost
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$213.80
Typical High
$363.08
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$1,096.48
Typical High
$3,548.13
United
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$181.97
Typical High
$309.03

Where South Carolina 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

South Carolina· 45th of 51

$558

$195 physician + $363 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.