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Radical Tonsil Area Removal With Flap Repair

Ohio 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?

$7,762

Typical facility fee. In Ohio, July 2026.

Insurers have agreed to pay about $7,762 for this service. Most negotiated rates run $3,388 to $12,589.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $7,762 · 10th to 90th $2,239 to $19,055
$1K$2K$5K$10K$20Kfacility $7,762

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
$2,398.83
Median
$7,244.36
Typical High
$12,589.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,238.72
Median
$9,549.93
Typical High
$21,877.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$1,584.89
Median
$2,187.76
Typical High
$2,691.53
Cigna
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$3,388.44
Typical High
$21,379.62
Medical Mutual of Ohio
Setting
Facility
Modifier
Global
Typical Low
$426.58
Median
$3,715.35
Typical High
$21,379.62
United
Setting
Facility
Modifier
Global
Typical Low
$575.44
Median
$2,691.53
Typical High
$5,754.40

Where Ohio 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.

Ohio· 7th of 50

$7,762

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.