Cost of a Tonsillectomy Visit
in Arkansas
Reviewed by Momentary Medical Group West PC
Arkansas ranks among the states with the highest rates of chronic tonsillitis, particularly in rural communities where access to preventive care remains limited. For patients needing specialized ENT care, Tonsillectomy visits typically cost 5% above national averages, with negotiated insurance rates ranging from $85 to $561 based on facility type and complexity. The state maintains 111 active Tonsillectomy providers across its 75 counties, though distribution varies significantly between urban centers like Little Rock and remote Delta regions.
Average
$348
Median
$399
Lowest
$85
Highest
$561
Providers
111
17% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Arkansas?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,138 | $1,894 | $2,603 | 99 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $90 | $1,839 | $2,535 | 109 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $85 | $746 | $1,042 | 118 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $479 | $752 | $1,034 | 99 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $416 | $929 | $1,328 | 117 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $85 | $840 | $1,236 | 140 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,180 | $1,600 | 113 |
| Septoplasty Nasal septum repair | 30520 | $433 | $887 | $1,074 | 102 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $461 | $734 | $1,043 | 96 |
| Mastectomy Partial or simple mastectomy | 19301 | $85 | $833 | $1,107 | 109 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $294 | $596 | $790 | 105 |
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 Arkansas
These hospitals in Arkansas are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
FAYETTEVILLE, AR
NASHVILLE, AR
LITTLE ROCK, AR
BRYANT, AR
NO LITTLE ROCK, AR
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 Arkansas
Arkansas healthcare costs run approximately 12% below national averages, reflecting lower practice overhead and physician compensation compared to coastal states. However, the state's rural geography creates significant access challenges, with 62 of 75 counties designated as medically underserved areas.
Urban vs. Rural Provider Availability
The majority of Arkansas's 111 Tonsillectomy providers cluster around Little Rock, Fort Smith, and Northwest Arkansas, leaving large swaths of the Delta and Ozark regions underserved. Rural patients often drive 2-3 hours to reach an ENT specialist, sometimes making Little Rock or Memphis their closest option. This geographic imbalance allows urban specialists to maintain higher rates while rural areas struggle with access rather than affordability.
Facility Type and Overhead Costs
Arkansas Children's Hospital, CHI St. Vincent, and Baptist Health dominate the hospital market, with their employed physician groups typically charging premium rates for specialty care. Independent ENT practices maintain lower overhead costs and often offer more competitive pricing, though they're increasingly rare as health systems acquire specialty groups. Academic medical centers like UAMS command the highest rates due to their teaching hospital status and complex case mix.
Insurance Market Competition in Arkansas
BCBS Arkansas's market dominance reduces competitive pressure on negotiated rates, while smaller insurers like QualChoice and UnitedHealthcare maintain more limited provider networks. The individual marketplace offers few insurer choices in most counties, limiting patient options for network access. This concentrated market structure tends to stabilize prices but may result in higher costs than more competitive insurance markets.
Physician Supply and Demand in Arkansas
With 111 active Tonsillectomy providers serving nearly 3 million residents, Arkansas falls below national averages for ENT specialist availability per capita. The state's medical school and residency programs struggle to retain graduates, with many specialists leaving for higher-paying markets after training. This supply shortage allows established providers to maintain strong pricing power, particularly for complex procedures and consultations.
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 Arkansas
What is the average cost of a Tonsillectomy visit in Arkansas without insurance?
Does Arkansas Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Arkansas?
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 Arkansas?
How does telemedicine affect the cost of seeing a Tonsillectomy in Arkansas?
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 |