go back

Radical Tonsil Area Removal With Flap Repair

Wisconsin 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?

$7,079

Typical facility fee. In Wisconsin, July 2026.

Insurers have agreed to pay about $7,079 for this service. Most negotiated rates run $4,266 to $11,220.

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 10 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $9,120 · 10th to 90th $2,512 to $18,197Professionalmedian $4,571 · 10th to 90th $2,512 to $7,079
$2K$5K$10K$20Kfacility $9,120professional $4,571

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
$2,454.71
Median
$4,466.84
Typical High
$14,454.40
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$6,606.93
Median
$10,964.78
Typical High
$20,892.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5,754.40
Median
$6,606.93
Typical High
$10,715.19
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$3,019.95
Typical High
$6,165.95
Medica
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,818.38
Typical High
$7,585.78
Network Health
Setting
Facility
Modifier
Global
Typical Low
$3,235.94
Median
$3,235.94
Typical High
$4,466.84
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,511.89
Typical High
$4,365.16
Quartz
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$4,570.88
Typical High
$7,079.46
Quartz
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$13,803.84
Typical High
$13,803.84
Security Health
Setting
Professional
Modifier
Global
Typical Low
$8,128.31
Median
$8,128.31
Typical High
$8,128.31
United
Setting
Facility
Modifier
Global
Typical Low
$1,905.46
Median
$5,370.32
Typical High
$20,892.96

Where Wisconsin 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.

Wisconsin· 9th of 50

$7,079

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.