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Drainage of an Abscess Near the Tonsil

South Dakota 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?

$1,065

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

Insurers have agreed to pay about $1,065 for this procedure. That total is two separate charges: $288 to the doctor who performs it, and $776 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$288$191 to $513
Facility feeThe hospital or surgery center$776$525 to $3,548

How much rates vary

Facilitymedian $776 · 10th to 90th $195 to $3,981Professionalmedian $288 · 10th to 90th $132 to $741
$100$200$500$1K$2Kfacility $776professional $288

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
$776.25
Median
$3,548.13
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$208.93
Typical High
$741.31
Cigna
Setting
Professional
Modifier
Global
Typical Low
$229.09
Median
$398.11
Typical High
$562.34
Medica
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$239.88
Typical High
$489.78
Medica
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$323.59
Typical High
$1,445.44
Midlands
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$338.84
Typical High
$436.52
Midlands
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$281.84
Typical High
$398.11
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$269.15
Typical High
$371.54
United
Setting
Facility
Modifier
Global
Typical Low
$812.83
Median
$812.83
Typical High
$812.83
United
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$263.03
Typical High
$426.58
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$331.13
Typical High
$512.86

Where South Dakota 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 Dakota· 25th of 51

$1,065

$288 physician + $776 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.