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Radical Tonsil Area Removal With Flap Repair

Virginia 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?

$3,311

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $3,311 for this service. Most negotiated rates run $2,512 to $7,244.

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 $3,388 · 10th to 90th $2,138 to $19,498Professionalmedian $2,455 · 10th to 90th $1,905 to $3,802
$1K$2K$5K$10K$20Kfacility $3,388professional $2,455

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
$2,511.89
Median
$5,011.87
Typical High
$14,125.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$8,511.38
Median
$19,054.61
Typical High
$26,302.68
Cigna
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$524.81
Typical High
$3,388.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,862.09
Median
$2,238.72
Typical High
$3,801.89
Medcost
Setting
Professional
Modifier
Global
Typical Low
$2,398.83
Median
$2,454.71
Typical High
$4,466.84
Medcost
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,818.38
Typical High
$4,365.16
Sentara
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,570.40
Typical High
$4,897.79
United
Setting
Facility
Modifier
Global
Typical Low
$436.52
Median
$2,884.03
Typical High
$6,309.57

Where Virginia 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.

Virginia· 28th of 50

$3,311

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.