Cost of a Tonsillectomy Visit
in Arizona
Reviewed by Momentary Medical Group West PC
Arizona's rapid population growth has led to increased demand for ENT specialists, with tonsillectomy procedures becoming more accessible across the state's expanding healthcare network. Based on negotiated insurance rates, Arizona patients typically pay between $240 and $480 for tonsillectomy-related visits, with a median cost of $240. The state maintains approximately 4,297 active providers offering tonsillectomy services, giving patients substantial choice when browsing all providers in Arizona.
Average
$320
Median
$240
Lowest
$240
Highest
$480
Providers
4,297
24% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Arizona?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,097 | $1,136 | $2,276 | 4,502 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $1,097 | $1,137 | $2,279 | 5,350 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $448 | $496 | $898 | 5,028 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $452 | $452 | $907 | 4,418 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $557 | $557 | $1,115 | 5,012 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $90 | $507 | $1,016 | 6,248 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $749 | $752 | $1,507 | 4,305 |
| Septoplasty Nasal septum repair | 30520 | $498 | $535 | $1,072 | 4,221 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $432 | $440 | $882 | 4,188 |
| Mastectomy Partial or simple mastectomy | 19301 | $525 | $553 | $1,108 | 4,299 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $352 | $364 | $729 | 4,203 |
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 Arizona
These hospitals in Arizona are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
PHOENIX, AZ
MESA, AZ
GOODYEAR, AZ
SCOTTSDALE, AZ
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 Arizona
Arizona's healthcare costs run approximately 5% above national averages, driven by rapid population growth and increasing demand for specialists across the state's diverse geographic regions. The state's mix of urban healthcare hubs and rural communities creates significant cost variations for specialized procedures like tonsillectomies.
Urban vs. Rural Provider Availability
Phoenix and Tucson metropolitan areas concentrate most of Arizona's ENT specialists, creating competitive pricing and shorter wait times for tonsillectomy consultations. Rural communities in northern Arizona and along the Mexican border often require patients to travel 100+ miles for specialized care, adding transportation costs and limiting provider choice. The state's vast geography means some patients face overnight stays for surgical procedures, increasing total treatment costs.
Facility Type and Overhead Costs
Banner Health and HonorHealth dominate Arizona's hospital market, with their ENT clinics typically charging higher facility fees than independent practices. Ambulatory surgery centers have expanded rapidly across Arizona, offering tonsillectomy procedures at 30-50% lower costs than hospital outpatient departments. Independent ENT practices, particularly common in suburban Phoenix and Tucson, often provide the most competitive consultation pricing.
Insurance Market Competition in Arizona
Arizona's insurance marketplace features strong competition between UHC, BCBS Arizona, and Aetna, leading to varied negotiated rates for tonsillectomy procedures across different plans. The state's lack of a dominant single insurer helps keep negotiated rates competitive, benefiting patients with lower out-of-pocket costs. Rural areas may have fewer in-network options, potentially forcing patients into higher-cost out-of-network care.
Physician Supply and Demand in Arizona
With approximately 4,297 active providers offering tonsillectomy services, Arizona maintains adequate specialist availability relative to its growing population. The state's attractive practice environment has drawn many ENT specialists from other regions, helping to moderate pricing pressure despite increasing demand. However, pediatric ENT subspecialists remain concentrated in major metropolitan areas, creating access challenges for rural families.
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 Arizona
What is the average cost of a Tonsillectomy visit in Arizona without insurance?
Does Arizona Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Arizona?
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 Arizona?
How does telemedicine affect the cost of seeing a Tonsillectomy in Arizona?
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 |