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Radical Tonsil Area Removal With Flap Repair

Pennsylvania 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.

Facilitymedian $5,370 · 10th–90th $1,000$8,5110%10%20%10th90th$5,370$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,047.13
Median
$5,754.40
Typical High
$8,511.38
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$20,417.38
Median
$21,379.62
Typical High
$57,543.99
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$794.33
Typical High
$3,715.35
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$3,981.07
Typical High
$8,317.64
Oscar Health
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,041.74
Typical High
$2,041.74
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$1,862.09
Typical High
$2,137.96
United
Setting
Facility
Modifier
Global
Typical Low
$398.11
Median
$2,290.87
Typical High
$6,309.57