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Radical Tonsil Area Removal With Flap Repair

New York 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?

$5,623

Typical facility fee. In New York, July 2026.

Insurers have agreed to pay about $5,623 for this service. Most negotiated rates run $3,090 to $9,333.

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 $5,623 · 10th to 90th $2,291 to $12,589
$1K$2K$5K$10Kfacility $5,623

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
$2,041.74
Median
$3,311.31
Typical High
$10,232.93
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$7,762.47
Typical High
$13,489.63
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$3,162.28
Typical High
$37,153.52
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,548.82
Median
$3,388.44
Typical High
$3,388.44
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$524.81
Median
$2,238.72
Typical High
$5,128.61
Excellus BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$50,118.72
Typical High
$75,857.76
United
Setting
Facility
Modifier
Global
Typical Low
$1,479.11
Median
$4,073.80
Typical High
$9,332.54
Univera
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$2,630.27
Typical High
$7,585.78

Where New York 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.

New York· 14th of 50

$5,623

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.