Cost of a Tonsillectomy Visit
in Alabama
Reviewed by Momentary Medical Group West PC
Alabama's rural healthcare landscape creates significant variations in Tonsillectomy costs across the state, with patients typically paying between $195 and $615, and a median out-of-pocket cost around $351. With 2,367 active Tonsillectomy providers throughout Alabama, patients have substantial options for finding quality care. Browse all Tonsillectomy providers across Alabama to compare costs and find the right specialist for your needs.
Average
$387
Median
$351
Lowest
$195
Highest
$615
Providers
2,367
8% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Alabama?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $964 | $1,625 | $2,946 | 2,353 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $80 | $1,512 | $2,767 | 2,636 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $418 | $688 | $1,195 | 2,384 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $382 | $619 | $1,165 | 2,356 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $450 | $822 | $1,450 | 2,367 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $80 | $672 | $1,208 | 2,672 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $608 | $1,138 | $1,856 | 2,372 |
| Septoplasty Nasal septum repair | 30520 | $433 | $687 | $1,315 | 2,358 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $356 | $598 | $1,111 | 2,352 |
| Mastectomy Partial or simple mastectomy | 19301 | $366 | $652 | $1,251 | 2,366 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $294 | $566 | $910 | 2,356 |
Important: These are cost estimates only — not a quote and not medical advice.
The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 42820 — Tonsillectomy and adenoidectomy). They represent what a patient might pay without insurance.
Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.
This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.
Where this data comes from & what CPT 42820 covers
Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 42820 (Tonsillectomy and adenoidectomy), as mandated by the CMS Price Transparency Rule.
What CPT 42820 covers: the provider's professional fee for tonsillectomy. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.
How to read this data
Negotiated Rate
The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.
P5, Median, P95
P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.
What this does not tell you
These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.
Top-Rated Hospitals in Alabama
These hospitals in Alabama are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
FAYETTE, AL
DADEVILLE, AL
PHENIX CITY, AL
BIRMINGHAM, AL
TROY, AL
Hospital ratings are based on HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey data published by CMS.
Why Tonsillectomy Visit Costs Vary Across Alabama
Alabama's Tonsillectomy costs average 8% below the national median, reflecting the state's lower overall healthcare spending and physician compensation rates. However, the state's significant rural-urban divide creates substantial cost variations, with metropolitan areas like Birmingham commanding premium rates while rural counties often struggle with provider shortages.
Urban vs. Rural Provider Availability
Alabama's 67 counties show stark disparities in ENT specialist access, with the Birmingham-Hoover and Huntsville metro areas containing the majority of pediatric otolaryngologists. Rural counties in the Black Belt region often have no local ENT specialists, forcing families to travel hours for Tonsillectomy consultations. This geographic maldistribution drives up total costs for rural patients despite lower base fees.
Facility Type and Overhead Costs
Large health systems like UAB Health System and Baptist Health dominate Alabama's urban markets, typically charging facility fees that can double the total cost of a Tonsillectomy consultation. Independent ENT practices, more common in mid-sized cities like Mobile and Montgomery, often offer more competitive pricing due to lower overhead costs. Surgery centers affiliated with hospitals generally fall somewhere between these two extremes.
Insurance Market Competition in Alabama
Blue Cross Blue Shield of Alabama's market dominance reduces competitive pressure on negotiated rates, contributing to relatively stable but sometimes higher costs in certain networks. The limited number of insurance options in Alabama's individual marketplace means fewer alternative rate structures for patients to choose from. This concentration gives providers less incentive to compete aggressively on price compared to more competitive insurance markets.
Physician Supply and Demand in Alabama
With 2,367 Tonsillectomy providers serving Alabama's 5.2 million residents, the state has adequate overall specialist supply but significant geographic maldistribution. Most ENT specialists cluster in the state's four major metropolitan areas, creating appointment delays and premium pricing in these markets. Rural areas face critical shortages, often requiring patients to wait weeks for consultations and travel significant distances for care.
Jayant Panwar
CEO, Momentary Labs · San Francisco, CA
Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.
The cost figures on this page reflect his ongoing work to make this data accessible to patients.
Frequently Asked Questions — Tonsillectomy Costs in Alabama
What is the average cost of a Tonsillectomy visit in Alabama without insurance?
Does Alabama Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Alabama?
What is the difference in cost between an initial consultation and a follow-up visit?
Can I use an HSA or FSA to pay for a Tonsillectomy visit in Alabama?
How does telemedicine affect the cost of seeing a Tonsillectomy in Alabama?
Click a state to compare costs
Average Visit Cost
Office visit (CPT 42820)
Compare With Other States
| Rank | State | Average↓ |
|---|---|---|
| 1 | Wisconsin Range: $95 – $1,404 | $682 |
| 2 | Massachusetts Range: $219 – $1,237 | $637 |
| 3 | Wyoming Range: $351 – $894 | $575 |
| 4 | Nebraska Range: $347 – $705 | $564 |
| 5 | New Hampshire Range: $290 – $831 | $556 |
| 6 | Georgia Range: $196 – $981 | $552 |
| 7 | Washington Range: $324 – $889 | $549 |
| 8 | Maine Range: $342 – $578 | $498 |
| 9 | North Dakota Range: $237 – $820 | $485 |
| 10 | Iowa Range: $95 – $705 | $480 |
| 11 | North Carolina Range: $217 – $820 | $478 |
| 12 | Rhode Island Range: $239 – $742 | $474 |
| 13 | District of Columbia Range: $220 – $681 | $460 |
| 14 | New Mexico Range: $253 – $694 | $459 |
| 15 | South Dakota Range: $197 – $705 | $438 |
| 16 | Missouri Range: $268 – $559 | $436 |
| 17 | Connecticut Range: $194 – $742 | $432 |
| 18 | New Jersey Range: $170 – $833 | $425 |
| 19 | Oregon Range: $85 – $774 | $424 |
| 20 | Vermont Range: $220 – $693 | $418 |
| 21 | Minnesota Range: $94 – $705 | $415 |
| 22 | Mississippi Range: $230 – $725 | $412 |
| 23 | Utah Range: $85 – $643 | $408 |
| 24 | Alaska Range: $85 – $768 | $408 |
| 25 | New York Range: $203 – $742 | $407 |
| 26 | Pennsylvania Range: $149 – $742 | $402 |
| 27 | Michigan Range: $238 – $559 | $402 |
| 28 | Illinois Range: $253 – $596 | $396 |
| 29 | West Virginia Range: $85 – $748 | $396 |
| 30 | Delaware Range: $154 – $698 | $390 |
| 31 | Colorado Range: $85 – $694 | $388 |
| 32 | Alabama Range: $195 – $615 | $387 |
| 33 | Tennessee Range: $234 – $559 | $386 |
| 34 | Idaho Range: $85 – $679 | $384 |
| 35 | Hawaii Range: $85 – $665 | $383 |
| 36 | South Carolina Range: $194 – $644 | $381 |
| 37 | Kentucky Range: $85 – $679 | $374 |
| 38 | Maryland Range: $226 – $607 | $368 |
| 39 | Virginia Range: $192 – $589 | $362 |
| 40 | Indiana Range: $85 – $649 | $360 |
| 41 | Kansas Range: $268 – $463 | $359 |
| 42 | Louisiana Range: $189 – $530 | $355 |
| 43 | Oklahoma Range: $232 – $540 | $354 |
| 44 | California Range: $80 – $705 | $350 |
| 45 | Arkansas Range: $85 – $561 | $348 |
| 46 | Texas Range: $85 – $597 | $332 |
| 47 | Nevada Range: $228 – $481 | $331 |
| 48 | Montana Range: $85 – $581 | $326 |
| 49 | Arizona Range: $240 – $480 | $320 |
| 50 | Ohio Range: $85 – $559 | $313 |
| 51 | Florida Range: $35 – $505 | $198 |