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Stopping Bleeding in the Throat

Virginia rates for HCPCS 42960

Controls bleeding at the back of the mouth and throat, most often after tonsil or adenoid surgery. The bleeding point is found and sealed, for example by cautery or a stitch, and the area is watched to be sure it stays dry. This covers the straightforward version, dealt with without a hospital admission or a return trip to the operating room.

Rates data updated July 2026.

How much does Stopping Bleeding in the Throat cost?

$316

Typical facility fee. In Virginia, July 2026.

Insurers have agreed to pay about $316 for this service. Most negotiated rates run $195 to $2,042.

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 $316 · 10th to 90th $174 to $5,248Professionalmedian $200 · 10th to 90th $145 to $347
$100$200$500$1K$2K$5K$10Kfacility $316professional $200

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
$281.84
Median
$2,570.40
Typical High
$7,079.46
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$2,570.40
Typical High
$2,951.21
Cigna
Setting
Facility
Modifier
Global
Typical Low
$257.04
Median
$309.03
Typical High
$363.08
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$141.25
Median
$169.82
Typical High
$346.74
Medcost
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$257.04
Typical High
$346.74
Medcost
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$218.78
Typical High
$338.84
Sentara
Setting
Facility
Modifier
Global
Typical Low
$162.18
Median
$208.93
Typical High
$707.95
United
Setting
Facility
Modifier
Global
Typical Low
$138.04
Median
$776.25
Typical High
$2,454.71

Where Virginia sits

The same service costs 79.4 times more in Maine than in North Dakota. 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· 40th of 50

$316

ME $13,183ND $166

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.