Cost of a Tonsillectomy Visit
in Louisiana
Reviewed by Momentary Medical Group West PC
Louisiana's healthcare system, heavily concentrated in New Orleans and Baton Rouge, serves a state where 18% of adults remain uninsured due to Medicaid non-expansion. Tonsillectomy patients typically pay between $189 and $530, with a median out-of-pocket cost of $346 based on negotiated insurance rates. The state maintains 904 active Tonsillectomy providers across its parishes, offering patients multiple options for surgical care from the Gulf Coast to the Arkansas border.
Average
$355
Median
$346
Lowest
$189
Highest
$530
Providers
904
16% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Louisiana?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $989 | $1,619 | $2,664 | 863 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $960 | $1,557 | $2,505 | 877 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $226 | $617 | $1,345 | 916 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $394 | $594 | $1,089 | 867 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $473 | $822 | $1,416 | 895 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $368 | $694 | $1,236 | 947 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $997 | $1,658 | 904 |
| Septoplasty Nasal septum repair | 30520 | $399 | $637 | $1,133 | 864 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $383 | $608 | $1,052 | 861 |
| Mastectomy Partial or simple mastectomy | 19301 | $331 | $636 | $1,229 | 905 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $294 | $504 | $979 | 865 |
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 Louisiana
These hospitals in Louisiana are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
COLUMBIA, LA
COVINGTON, LA
LAFAYETTE, LA
ALEXANDRIA, LA
BATON ROUGE, LA
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 Louisiana
Louisiana's healthcare costs run approximately 1% above national averages, driven by limited rural access and concentration of specialty services in New Orleans, Baton Rouge, and Shreveport. The state's high uninsured rate due to Medicaid non-expansion creates unique market dynamics where self-pay pricing becomes particularly important for surgical procedures.
Urban vs. Rural Provider Availability
Louisiana's 64 parishes create significant geographic disparities in ENT access, with patients in rural areas like the Florida Parishes often traveling 50+ miles to reach surgical centers. Metropolitan areas like Greater New Orleans and Baton Rouge offer multiple surgical options, while northern and southwestern parishes may have limited choices, affecting both cost and scheduling flexibility.
Facility Type and Overhead Costs
Hospital-owned outpatient surgical centers typically charge higher facility fees than independent ambulatory surgery centers in Louisiana, with academic medical centers like Ochsner and LSU Health commanding premium rates. Independent surgery centers, particularly common in suburban New Orleans and Baton Rouge, often provide the same quality care at significantly lower facility costs.
Insurance Market Competition in Louisiana
Louisiana's insurance market shows moderate competition with Blue Cross Blue Shield Louisiana holding significant market share alongside UnitedHealthcare and Aetna. This concentration allows for relatively stable negotiated rates but limits price competition compared to states with more diverse insurer participation, keeping surgical costs fairly consistent across the state.
Physician Supply and Demand in Louisiana
With 904 active Tonsillectomy providers serving Louisiana's 4.6 million residents, the state maintains adequate ENT coverage in urban areas but faces shortages in rural parishes. This supply distribution creates longer wait times and potentially higher costs in underserved regions, while metropolitan areas benefit from competitive pricing among multiple qualified surgeons.
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 Louisiana
What is the average cost of a Tonsillectomy visit in Louisiana without insurance?
Does Louisiana Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Louisiana?
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 Louisiana?
How does telemedicine affect the cost of seeing a Tonsillectomy in Louisiana?
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 |