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Radical Tonsil Area Removal With Flap Repair

Washington, DC 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?

$2,570

Typical facility fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $2,570 for this service. Most negotiated rates run $2,138 to $4,074.

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 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,570 · 10th to 90th $1,698 to $7,762Professionalmedian $2,138 · 10th to 90th $2,042 to $4,571
$1K$2K$5K$10Kfacility $2,570professional $2,138

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
$1,698.24
Median
$2,570.40
Typical High
$7,762.47
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$2,041.74
Median
$2,137.96
Typical High
$4,570.88
United
Setting
Facility
Modifier
Global
Typical Low
$645.65
Median
$2,089.30
Typical High
$16,218.10

Where Washington, DC 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.

Washington, DC· 39th of 50

$2,570

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.