Cost of a Tonsillectomy Visit
in Nebraska
Reviewed by Momentary Medical Group West PC
Nebraska's healthcare system serves a largely rural population across 93 counties, with most specialists concentrated in Omaha and Lincoln metropolitan areas. Tonsillectomy patients typically pay between $347 and $705 for surgical procedures, with a median cost of $640 based on insurance negotiated rates. With over 2,100 active providers offering tonsillectomy services statewide, patients can browse all qualified providers throughout Nebraska to find the best combination of cost and convenience.
Average
$564
Median
$640
Lowest
$347
Highest
$705
Providers
2,176
34% above national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Nebraska?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,637 | $2,935 | $3,009 | 2,178 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $1,627 | $2,938 | $3,012 | 2,188 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $641 | $1,209 | $1,313 | 2,182 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $655 | $1,174 | $1,294 | 2,183 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $796 | $1,428 | $1,526 | 2,193 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $726 | $1,304 | $1,396 | 2,202 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $1,076 | $1,972 | $2,164 | 2,184 |
| Septoplasty Nasal septum repair | 30520 | $765 | $1,426 | $1,627 | 2,181 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $637 | $1,131 | $1,214 | 2,174 |
| Mastectomy Partial or simple mastectomy | 19301 | $760 | $1,392 | $1,529 | 2,177 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $513 | $939 | $1,068 | 2,178 |
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 Nebraska
These hospitals in Nebraska are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
OMAHA, NE
OMAHA, NE
SUPERIOR, NE
OMAHA, NE
HOLDREGE, NE
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 Nebraska
Healthcare costs in Nebraska run approximately 1% below national averages, reflecting the state's lower cost of living and competitive provider market. The concentration of major medical facilities in Omaha and Lincoln creates cost disparities with rural areas, where patients may travel significant distances for specialized surgical care.
Urban vs. Rural Provider Availability
Omaha and Lincoln metropolitan areas house most of Nebraska's ENT specialists, with rural patients often traveling 100+ miles for tonsillectomy procedures. This geographic concentration allows urban practices to maintain higher volume and potentially lower per-procedure costs. Telehealth consultations help bridge distance gaps for follow-up care, though initial surgical consultations typically require in-person evaluation.
Facility Type and Overhead Costs
Hospital-owned outpatient surgery centers like those at Nebraska Medicine and CHI Health typically charge higher facility fees than independent ambulatory surgery centers. Academic medical centers command premium pricing due to teaching hospital overhead and specialized equipment. Smaller community hospitals in rural Nebraska may offer more competitive rates but with potentially longer wait times for elective procedures.
Insurance Market Competition in Nebraska
BCBS Nebraska, UHC, and Aetna dominate the state's insurance landscape, with moderate competition helping keep negotiated rates reasonable compared to more monopolistic markets. Rural areas often have fewer plan options, potentially limiting patients' ability to shop for better surgical coverage. The state's lack of a public insurance marketplace affects plan variety and pricing transparency.
Physician Supply and Demand in Nebraska
With over 2,100 providers offering tonsillectomy services, Nebraska maintains adequate surgical capacity relative to its population of 1.9 million residents. Most ENT specialists cluster around major metropolitan areas, creating potential access challenges for rural residents. Strong medical training programs at UNMC help maintain physician supply, though recruitment to rural areas remains challenging for specialized surgical services.
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 Nebraska
What is the average cost of a Tonsillectomy visit in Nebraska without insurance?
Does Nebraska Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Nebraska?
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 Nebraska?
How does telemedicine affect the cost of seeing a Tonsillectomy in Nebraska?
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 |