go back

Drainage of an Abscess Near the Tonsil

Utah 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?

$2,854

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

Insurers have agreed to pay about $2,854 for this procedure. That total is two separate charges: $224 to the doctor who performs it, and $2,630 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$224$174 to $380
Facility feeThe hospital or surgery center$2,630$372 to $3,388

How much rates vary

Facilitymedian $2,630 · 10th to 90th $251 to $4,571Professionalmedian $224 · 10th to 90th $138 to $692
$200$500$1K$2K$5Kfacility $2,630professional $224

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
$251.19
Median
$2,951.21
Typical High
$4,570.88
Aetna
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$223.87
Typical High
$758.58
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$223.87
Typical High
$398.11
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$389.05
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$331.13
Median
$467.74
Typical High
$691.83
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$177.83
Median
$257.04
Typical High
$363.08
Select Health
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$389.05
Typical High
$389.05
Select Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$245.47
Typical High
$389.05
U of Utah Health Plan
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$245.47
Typical High
$354.81
United
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$4,466.84
Typical High
$5,128.61
United
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$190.55
Typical High
$309.03

Where Utah 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

Utah· 7th of 51

$2,854

$224 physician + $2,630 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.