Cost of a Tonsillectomy Visit
in Texas
Reviewed by Momentary Medical Group West PC
Texas operates one of the nation's largest healthcare markets with over 600 ambulatory surgery centers, creating competitive pricing for surgical procedures like tonsillectomy. Patients typically pay between $85 and $597 for a tonsillectomy procedure, with a median negotiated rate of $313. With nearly 6,000 active providers performing tonsillectomies across the state, Texas residents have extensive options for finding quality care at competitive rates.
Average
$332
Median
$313
Lowest
$85
Highest
$597
Providers
5,861
21% below national average
Compare Similar Procedures
How does tonsillectomy compare to related procedures in Texas?
| Procedure | CPT | Low | Median | High | Providers |
|---|---|---|---|---|---|
| IUD Removal Cost of intrauterine device (IUD) removal across the US, with state-by-state pricing for both office-based and hospital outpatient settings. | 58301 | $60 | $105 | $199 | 6,391 |
| Knee Replacement Total knee replacement (arthroplasty) | 27447 | $1,056 | $1,568 | $3,006 | 5,230 |
| Hip Replacement Total hip replacement (arthroplasty) | 27130 | $90 | $1,139 | $2,602 | 8,415 |
| Cataract Surgery Cataract extraction with intraocular lens insertion | 66984 | $85 | $691 | $1,210 | 6,544 |
| Knee Arthroscopy Arthroscopy of the knee with meniscectomy | 29881 | $421 | $625 | $1,250 | 5,233 |
| Gallbladder Removal (Laparoscopic) Laparoscopic cholecystectomy | 47562 | $90 | $776 | $1,300 | 11,548 |
| Appendectomy (Laparoscopic) Laparoscopic appendectomy | 44970 | $85 | $663 | $1,155 | 13,126 |
| Hysterectomy (Laparoscopic) Laparoscopic total hysterectomy | 58571 | $85 | $977 | $1,912 | 5,874 |
| Septoplasty Nasal septum repair | 30520 | $90 | $638 | $1,309 | 7,864 |
| Inguinal Hernia Repair Inguinal hernia repair | 49505 | $407 | $602 | $1,086 | 5,176 |
| Mastectomy Partial or simple mastectomy | 19301 | $85 | $722 | $1,341 | 5,830 |
| Carpal Tunnel Surgery Open carpal tunnel release | 64721 | $90 | $469 | $895 | 8,448 |
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 Texas
These hospitals in Texas are top-rated for patient satisfaction. Review data sourced from HCAHPS Patient Survey.
BRYAN, TX
AMARILLO, TX
SAN ANTONIO, TX
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 Texas
Texas tonsillectomy costs run approximately 4% below the national average, reflecting the state's competitive healthcare market and lower overall operating costs compared to coastal states. The state's vast geography creates significant cost variations, with major metropolitan areas offering more competitive pricing due to higher provider density and facility competition.
Urban vs. Rural Provider Availability
Major Texas metropolitan areas like Dallas-Fort Worth, Houston, San Antonio, and Austin have abundant ENT specialists and surgical facilities, creating competitive pricing for tonsillectomy procedures. Rural counties often have limited surgical options, requiring patients to travel to regional medical centers for procedures, which can increase total care costs. The distance between rural communities and surgical centers also affects post-operative follow-up accessibility and costs.
Facility Type and Overhead Costs
Texas has a robust network of ambulatory surgery centers that typically offer lower facility fees than hospital-based surgical suites. Major health systems like Houston Methodist, Baylor Scott & White, and UT Southwestern operate multiple surgical locations with varying cost structures. Independent surgical centers often provide the most competitive pricing due to lower overhead costs compared to hospital-owned facilities.
Insurance Market Competition in Texas
The presence of multiple major insurers including UnitedHealthcare, Blue Cross Blue Shield of Texas, Aetna, and Cigna creates competitive negotiated rates with providers. Texas's large insurance market gives these payers significant leverage in rate negotiations, contributing to below-average costs for surgical procedures. The competitive landscape also encourages providers to offer transparent pricing and patient-friendly payment options.
Physician Supply and Demand in Texas
With nearly 6,000 providers performing tonsillectomy procedures across Texas, the state has adequate surgical capacity in most regions. This robust provider supply helps maintain competitive pricing and shorter wait times for elective procedures in metropolitan areas. Rural areas may have limited local options, but the overall statewide supply prevents significant access bottlenecks for most patients.
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 Texas
What is the average cost of a Tonsillectomy visit in Texas without insurance?
Does Texas Medicaid cover Tonsillectomy visits?
How do I find an affordable Tonsillectomy near me in Texas?
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 Texas?
How does telemedicine affect the cost of seeing a Tonsillectomy in Texas?
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 |