How Much Does a Tonsillectomy Cost?
Data from 1412 hospitals · CPT codes: 42826, 42825
Cash Price vs Insured Rate
Average Cash Price
$3,527
What hospitals charge patients paying out of pocket without insurance.
Average Negotiated Rate
$3,701
What insurance companies have negotiated to pay on your behalf.
Price by State
Cheapest States
| State | Avg Price | Hospitals |
|---|---|---|
| VT | $1565 | 7 |
| MI | $1733 | 51 |
| WY | $1933 | 6 |
| SD | $2004 | 9 |
| MO | $2086 | 34 |
Most Expensive States
| State | Avg Price | Hospitals |
|---|---|---|
| SC | $11574 | 13 |
| NM | $8344 | 15 |
| CA | $7133 | 115 |
| VA | $6248 | 37 |
| WA | $5540 | 19 |
Price Distribution
How Tonsillectomy prices are distributed across hospitals.
Key Insights
Price Variation
Tonsillectomy prices range from $1 to $38,543 — a 55062x difference. Even within the typical range (25th-75th percentile), prices vary by 598%.
Cash vs Insurance
The average cash price ($3,527) is -5% higher than the average negotiated rate ($3,701). However, if you haven't met your deductible, paying cash may sometimes be cheaper.
Geographic Variation
The cheapest state for Tonsillectomy (VT, avg $1565) is 639% cheaper than the most expensive (SC, avg $11574).
Saving Tips
Compare prices at multiple facilities before scheduling. Ask about the self-pay or cash discount — many hospitals offer 20-40% off when you pay upfront. Consider freestanding imaging centers for Tonsillectomy, which often charge significantly less than hospital-based facilities.
Compare Tonsillectomy Prices Near You
Search real prices from 1412 hospitals reporting Tonsillectomy prices.
Compare Prices NowHow to Save on Tonsillectomy
Tips for reducing your cost:
- Compare facility types -- imaging centers and ambulatory surgery centers (ASCs) are typically 30-50% less expensive than hospitals for the same procedure. The price difference is driven by lower overhead, not lower quality.
- Ask about cash/self-pay discounts -- many facilities offer 20-40% off their published rate for patients who pay upfront without using insurance. This is especially valuable if you have not met your deductible.
- Check your insurance benefits before scheduling -- know your deductible status, coinsurance rate, and whether the facility is in-network. A 5-minute call to your insurer can prevent a surprise bill.
- Get a price estimate in advance -- you have the legal right to a Good Faith Estimate under the No Surprises Act. Request one from every facility you are considering.
- Consider traveling -- facilities 30-60 minutes away may save you hundreds or even thousands of dollars. Use our comparison tool to check prices in neighboring areas.
Understanding Your Tonsillectomy Bill
What to expect on your bill:
- Facility fee: covers the room, equipment, and nursing staff. This is the largest component and the most variable across facilities.
- Professional fee: the doctor performing or reading the procedure. This is billed separately, often by a different provider group.
- Anesthesia (if applicable): billed separately by the anesthesiologist or CRNA, typically per time unit.
- Supplies/contrast: medications, contrast dye, or materials used during the procedure may appear as separate line items.
Each component may generate a separate bill from a different provider. Ask for a bundled quote before scheduling to avoid surprises. Learn more in our guide to understanding medical bills.
About This Data
Our pricing data comes from two government-mandated sources:
- Hospital Chargemaster Files -- published by 7,400+ hospitals as required by CMS since January 2021. These files contain gross charges, cash prices, and payer-specific negotiated rates.
- Insurance Carrier MRFs -- negotiated rates published by Aetna, Blue Cross Blue Shield, Cigna, Kaiser Permanente, and UnitedHealthcare under the Transparency in Coverage rule.
All prices shown are real published rates, not estimates. Data is updated monthly. For full details on our collection and validation process, see our methodology page or our about the data page.
Brad has 30 years of experience in strategy and healthcare innovation, including roles as CEO of Lane Health and Flipt, SVP at TE Connectivity, and Partner at McKinsey. He holds an MBA from Wharton and a BS from Duke University.
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