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Wide Removal of the Tonsil and Nearby Tissue

Ohio rates for HCPCS 42842

Removes a tonsil together with the folds of tissue on either side of it and, where involved, the strip of gum behind the last lower molar, taking a margin of surrounding tissue along with the growth. The raw surface is left to heal on its own rather than being covered with tissue moved in from elsewhere. It is used for cancer of that part of the mouth and throat.

Rates data updated July 2026.

How much does Wide Removal of the Tonsil and Nearby Tissue cost?

$4,898

Typical facility fee. In Ohio, July 2026.

Insurers have agreed to pay about $4,898 for this service. Most negotiated rates run $2,692 to $10,715.

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.

How much rates vary

Facilitymedian $4,898 · 10th to 90th $1,072 to $12,589
$1K$2K$5K$10K$20Kfacility $4,898

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
$1,096.48
Median
$8,912.51
Typical High
$12,589.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$1,071.52
Median
$4,168.69
Typical High
$16,982.44
CareSource
Setting
Facility
Modifier
Global
Typical Low
$933.25
Median
$1,071.52
Typical High
$1,737.80
Cigna
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,202.26
Typical High
$1,584.89
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$1,202.26
Typical High
$1,659.59
SummaCare
Setting
Facility
Modifier
Global
Typical Low
$9,120.11
Median
$9,120.11
Typical High
$9,120.11
United
Setting
Facility
Modifier
Global
Typical Low
$870.96
Median
$4,466.84
Typical High
$8,128.31

Where Ohio sits

The same service costs 22.4 times more in Indiana than in Maine. 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.

Ohio· 13th of 50

$4,898

IN $15,488ME $692

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.