Cost of a Tonsillectomy Visit
in Georgia
Reviewed by Momentary Medical Group West PC
Georgia's healthcare market operates roughly 1% below national cost averages, with over 3,000 active Tonsillectomy providers serving patients across the state's diverse urban and rural communities. Tonsillectomy visit costs typically range from $196 to $981, with a median rate of $479 based on negotiated insurance rates. You can browse all qualified Tonsillectomy specialists throughout Georgia to find the right provider for your needs.
Average
$552
Median
$479
Lowest
$196
Highest
$981
Providers
3,030
31% above national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Georgia?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,131 | $2,136 | $5,082 | 2,851 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $1,115 | $2,021 | $5,088 | 2,920 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $93 | $811 | $2,005 | 3,287 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $450 | $854 | $2,024 | 2,855 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $553 | $1,141 | $2,490 | 2,917 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $85 | $976 | $2,038 | 3,158 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,337 | $2,855 | 3,043 |
| Septoplasty Nasal septum repair | 30520 | $499 | $950 | $2,190 | 2,853 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $421 | $902 | $1,969 | 2,843 |
| Mastectomy Partial or simple mastectomy | 19301 | $350 | $982 | $2,473 | 3,025 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $344 | $646 | $1,930 | 2,848 |
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 Georgia
These hospitals in Georgia are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
BREMEN, GA
REIDSVILLE, GA
CHATSWORTH, GA
Fort Gordon, GA
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 Georgia
Georgia's healthcare costs run approximately 1% below the national average, driven by lower facility overhead outside Atlanta and competitive pressure from the state's large provider networks. The state's mix of major metropolitan areas and extensive rural counties creates significant cost variations for specialist care like Tonsillectomy services.
Urban vs. Rural Provider Availability
Atlanta's metro area concentrates most of Georgia's ENT specialists, while rural counties in south and central Georgia face significant provider shortages. Patients in Columbus, Augusta, and Savannah have reasonable access to Tonsillectomy care, but those in smaller towns may need to travel considerable distances or face longer wait times.
Facility Type and Overhead Costs
Hospital-owned practices dominate Georgia's major markets, with systems like Emory Healthcare, Piedmont, and Augusta University Health controlling significant market share. These hospital-affiliated clinics typically charge higher facility fees compared to independent ENT practices, which remain more common in smaller cities and suburban areas.
Insurance Market Competition in Georgia
Anthem Blue Cross Blue Shield holds the largest market share in Georgia, followed by UnitedHealthcare and Cigna, creating moderate competition that helps keep negotiated rates reasonable. The state's decision to use the federal marketplace rather than create its own exchange has limited some insurer participation, potentially reducing competitive pressure in certain regions.
Physician Supply and Demand in Georgia
With over 3,000 active Tonsillectomy providers statewide, Georgia has adequate specialist supply in urban areas but significant shortages in rural counties. This supply-demand imbalance keeps wait times and prices higher in underserved areas while creating competitive pricing in Atlanta and other metropolitan markets.
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 Georgia
What is the average cost of a Tonsillectomy visit in Georgia without insurance?
Does Georgia Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Georgia?
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 Georgia?
How does telemedicine affect the cost of seeing a Tonsillectomy in Georgia?
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 |
