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Radical Tonsil Area Removal With Flap Repair

North Carolina 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?

$2,692

Typical facility fee. In North Carolina, July 2026.

Insurers have agreed to pay about $2,692 for this service. Most negotiated rates run $2,188 to $3,715.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $2,692 · 10th to 90th $1,820 to $6,310Professionalmedian $3,020 · 10th to 90th $3,020 to $3,020
$500$1K$2K$5K$10Kfacility $2,692professional $3,020

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. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,659.59
Median
$5,370.32
Typical High
$8,709.64
Cigna
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$512.86
Typical High
$35,481.34
Medcost
Setting
Professional
Modifier
Global
Typical Low
$3,019.95
Median
$3,019.95
Typical High
$3,019.95
Medcost
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$2,630.27
Typical High
$4,265.80
United
Setting
Facility
Modifier
Global
Typical Low
$323.59
Median
$2,041.74
Typical High
$6,456.54
Wellcare
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$13,803.84
Typical High
$13,803.84

Where North Carolina 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.

North Carolina· 38th of 50

$2,692

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.