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Radical Tonsil Area Removal With Flap Repair

California rates for HCPCS 42845

Removes a cancer involving the tonsil, the folds of tissue around it and the area behind the back teeth, taking a wide margin of surrounding tissue, then rebuilds the site with a flap of tissue brought in from elsewhere in the body. Bringing in tissue with its own blood supply fills the gap and helps swallowing and speech recover. It is a lengthy operation, usually part of a wider cancer treatment plan.

Rates data updated July 2026.

How much does Radical Tonsil Area Removal With Flap Repair cost?

$9,120

Typical facility fee. In California, July 2026.

Insurers have agreed to pay about $9,120 for this service. Most negotiated rates run $5,012 to $13,804.

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.

How much rates vary

Facilitymedian $10,000 · 10th to 90th $2,818 to $17,783Professionalmedian $2,239 · 10th to 90th $1,698 to $4,571
$100$500$2K$10Kfacility $10,000professional $2,239

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
$3,715.35
Median
$10,000.00
Typical High
$22,908.68
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,456.54
Median
$11,481.54
Typical High
$17,782.79
Blue Shield
Setting
Facility
Modifier
Global
Typical Low
$67.61
Median
$5,011.87
Typical High
$10,232.93
Cigna
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$758.58
Typical High
$2,398.83
Contra Costa Health
Setting
Professional
Modifier
Global
Typical Low
$1,479.11
Median
$1,995.26
Typical High
$2,884.03
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,778.28
Median
$2,238.72
Typical High
$4,677.35
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$54.95
Median
$56.23
Typical High
$13,803.84
Providence
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$2,691.53
Typical High
$4,365.16
United
Setting
Facility
Modifier
Global
Typical Low
$1,737.80
Median
$5,623.41
Typical High
$17,378.01

Where California sits

The same service costs 17.4 times more in Maine than in Wyoming. 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.

California· 4th of 50

$9,120

ME $22,387WY $1,288

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.