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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.

Rates data updated July 2026.

How much does Radical Tonsil Area Removal With Flap Repair cost?

$5,370

Typical facility fee. In Pennsylvania, July 2026.

Insurers have agreed to pay about $5,370 for this service. Most negotiated rates run $2,344 to $7,762.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,370 · 10th to 90th $1,023 to $8,511
$500$1K$2K$5K$10K$20Kfacility $5,370

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
$1,412.54
Median
$5,370.32
Typical High
$8,317.64
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
$501.19
Median
$2,089.30
Typical High
$36,307.81
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
$4,786.30
Typical High
$8,317.64
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1,862.09
Median
$2,137.96
Typical High
$5,623.41
United
Setting
Facility
Modifier
Global
Typical Low
$389.05
Median
$2,344.23
Typical High
$6,309.57

Where Pennsylvania 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.

Pennsylvania· 15th of 50

$5,370

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.