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Radical Tonsil Area Removal With Flap Repair

Illinois 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?

$3,548

Typical facility fee. In Illinois, July 2026.

Insurers have agreed to pay about $3,548 for this service. Most negotiated rates run $2,239 to $7,943.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,236 · 10th to 90th $1,148 to $9,772Professionalmedian $3,802 · 10th to 90th $2,188 to $10,715
$200$500$1K$2K$5K$10K$20Kfacility $3,236professional $3,802

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
$1,148.15
Median
$3,235.94
Typical High
$7,762.47
BCBS
Setting
Facility
Modifier
Global
Typical Low
$9,549.93
Median
$24,547.09
Typical High
$47,863.01
Cigna
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$398.11
Typical High
$588.84
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$2,187.76
Median
$3,801.89
Typical High
$10,715.19
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$2,818.38
Typical High
$7,413.10

Where Illinois 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.

Illinois· 24th of 50

$3,548

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.