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Radical Tonsil Area Removal With Flap Repair

Vermont 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 October 2026.

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

$3,162

Typical physician fee. In Vermont, October 2026.

Insurers have agreed to pay about $3,162 for this service. Most negotiated rates run $2,754 to $3,311.

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 4 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $776 · 10th to 90th $468 to $776Professionalmedian $3,162 · 10th to 90th $2,455 to $3,802
$500$1K$2K$5K$10Kfacility $776professional $3,162

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$2,454.71
Typical High
$3,019.95
Cigna
Setting
Facility
Modifier
None
Typical Low
$467.74
Median
$467.74
Typical High
$467.74
Cigna
Setting
Professional
Modifier
None
Typical Low
$2,511.89
Median
$3,311.31
Typical High
$3,311.31
MVP Health Care
Setting
Professional
Modifier
None
Typical Low
$2,344.23
Median
$3,162.28
Typical High
$5,754.40
United
Setting
Facility
Modifier
None
Typical Low
$776.25
Median
$776.25
Typical High
$776.25
United
Setting
Professional
Modifier
None
Typical Low
$2,454.71
Median
$3,162.28
Typical High
$4,570.88

Where Vermont sits

The same service costs 5.5 times more in Alaska than in Texas. 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.

Vermont· 16th of 51

$3,162

AK $7,413TX $1,349

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.