Cost of a Tonsillectomy Visit
in Minnesota
Reviewed by Momentary Medical Group West PC
Minnesota's healthcare market operates approximately 2% above national cost averages, influenced by the state's robust network of integrated health systems and expanded Medicaid coverage. Tonsillectomy patients typically pay between $93.60 and $704.89, with a median out-of-pocket cost of $447.42 across 344 active providers throughout the state. Minnesota maintains strong provider accessibility from the Twin Cities metro to rural northern counties, allowing patients to browse all qualified tonsillectomy specialists statewide.
Average
$415
Median
$447
Lowest
$94
Highest
$705
Providers
344
1% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Minnesota?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $873 | $2,164 | $5,078 | 478 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $91 | $91 | $3,227 | 1,859 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $90 | $763 | $1,548 | 375 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $338 | $892 | $2,258 | 491 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $444 | $6,146 | $6,146 | 1,845 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $80 | $898 | $2,095 | 511 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $1,311 | $3,576 | 484 |
| Septoplasty Nasal septum repair | 30520 | $91 | $808 | $1,627 | 341 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $344 | $778 | $1,787 | 410 |
| Mastectomy Partial or simple mastectomy | 19301 | $445 | $953 | $2,393 | 418 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $358 | $722 | $1,930 | 403 |
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 Minnesota
These hospitals in Minnesota are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
ST PETER, MN
GLENWOOD, MN
PERHAM, MN
CLOQUET, MN
AITKIN, MN
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 Minnesota
Minnesota healthcare costs run approximately 2% above national averages, driven by the state's high concentration of world-class medical facilities and integrated health systems that command premium rates. The state's robust insurance market and Medicaid expansion help moderate out-of-pocket expenses, though geographic disparities between metropolitan and rural areas create notable cost variations for surgical procedures like tonsillectomy.
Urban vs. Rural Provider Availability
The Twin Cities metro area concentrates the majority of Minnesota's ENT specialists, creating competitive pricing in Minneapolis and St. Paul while rural regions like northern Minnesota may have limited options requiring longer travel distances. Patients in areas like Duluth, Rochester, and St. Cloud benefit from regional medical centers, but those in truly rural counties often face higher costs due to reduced provider competition and increased facility overhead.
Facility Type and Overhead Costs
Minnesota's healthcare landscape includes major integrated systems like Mayo Clinic, Allina Health, M Health Fairview, and Essentia Health, with hospital-owned surgical centers typically charging higher facility fees than independent ambulatory surgery centers. These large health systems often provide comprehensive services and advanced technology but may carry premium pricing compared to smaller, independent ENT practices operating their own surgical facilities.
Insurance Market Competition in Minnesota
BCBS Minnesota, UnitedHealthcare, and HealthPartners dominate the state's insurance market, creating moderate competition that helps control negotiated rates for surgical procedures. This three-way market dynamic prevents monopolistic pricing while maintaining stable provider networks, though patients may find significant cost differences between insurers for identical tonsillectomy procedures depending on specific contract negotiations with ENT groups.
Physician Supply and Demand in Minnesota
With 344 active tonsillectomy providers serving Minnesota's 5.7 million residents, the state maintains adequate ENT specialist availability compared to national averages, particularly in metropolitan areas. This healthy provider supply helps moderate pricing pressure and reduces wait times for consultations, though rural areas still experience some access challenges that can drive patients toward higher-cost urban facilities for surgical 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 Minnesota
What is the average cost of a Tonsillectomy visit in Minnesota without insurance?
Does Minnesota Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Minnesota?
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 Minnesota?
How does telemedicine affect the cost of seeing a Tonsillectomy in Minnesota?
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 |