Drainage of a tonsil abscess

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

I&D Abscess Peritonsillar

Payers reporting CPT 42700

Payer pricing summary

Low

$168

Average

$780

Median

$533

High

$4.7k

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +36 other terms	419	$410	$919	$1.7k	187%	3–30	$0 – $18.0k
2	Bcbs Al facility · other · outpatient · +6 other terms	3	$160	$154	$34	22%	3–30	$110 – $192
3	UnitedHealthcare fee schedule · outpatient · +40 other terms	598	$259	$670	$1.2k	186%	2–20	$1 – $17.9k
4	Anthem fee schedule · outpatient · +32 other terms	144	$233	$434	$758	175%	2–20	$42 – $6.3k
5	Bcbs Mt fee schedule · outpatient · +1 other terms	1	$533	$533	—	—	2–20	$533 – $533
6	Humana fee schedule · outpatient · +30 other terms	410	$232	$373	$778	208%	1–10	$1 – $12.8k
7	Molina fee schedule · outpatient · +31 other terms	245	$198	$222	$395	178%	1–10	$1 – $5.8k
8	Kaiser fee schedule · outpatient · +25 other terms	105	$310	$465	$612	131%	1–10	$12 – $4.3k
9	Aetna fee schedule · outpatient · +37 other terms	534	$277	$825	$1.7k	206%	—	$1 – $21.3k
10	Cigna case rate · outpatient · +34 other terms	314	$3.0k	$4.7k	$6.1k	131%	—	$1 – $40.7k
11	WellCare fee schedule · outpatient · +24 other terms	180	$237	$302	$477	158%	—	$81 – $4.3k
12	Oscar case rate · outpatient · +23 other terms	136	$2.6k	$2.7k	$684	26%	—	$363 – $7.5k
13	MultiPlan fee schedule · outpatient · +23 other terms	104	$452	$507	$505	100%	—	$89 – $7.3k
14	Ambetter fee schedule · outpatient · +21 other terms	101	$415	$423	$273	65%	—	$48 – $2.3k
15	Aetna Better Health fee schedule · outpatient · +21 other terms	84	$111	$150	$97	65%	—	$96 – $816
16	Devoted facility · fee schedule · outpatient · +18 other terms	77	$224	$324	$633	195%	—	$66 – $4.9k
17	Optum fee schedule · outpatient · +24 other terms	73	$213	$240	$135	56%	—	$105 – $874
18	Tricare facility · fee schedule · outpatient · +19 other terms	67	$241	$1.1k	$1.9k	173%	—	$61 – $6.1k
19	Caresource fee schedule · outpatient · +19 other terms	65	$255	$653	$640	98%	—	$1 – $4.3k
20	Highmark facility · fee schedule · outpatient · +18 other terms	61	$375	$662	$778	118%	—	$65 – $3.8k
21	Amerihealth Caritas facility · fee schedule · outpatient · +13 other terms	46	$148	$323	$1.1k	343%	—	$62 – $9.5k
22	Cigna Healthspring fee schedule · outpatient · +11 other terms	39	$152	$184	$65	35%	—	$92 – $253
23	Healthcare Highways case rate · outpatient · +4 other terms	39	$5.8k	$6.6k	$5.1k	77%	—	$2.1k – $14.6k
24	First Health fee schedule · outpatient · +23 other terms	38	$301	$971	$2.1k	216%	—	$88 – $7.2k
25	Superior Healthplan case rate · outpatient · +5 other terms	38	$948	$934	$82	9%	—	$349 – $948

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