Tonsillectomy is a surgical procedure. Prices are from 1475 US hospitals across 52 states, from their machine-readable files.
Price comparison (median)
Typical cash price here is $3,930 — about 15.6× the Medicare rate ($252). High vs Medicare. A fair cash price is usually within ~2× Medicare ($504).
💡 Asking for the cash price instead of the $5,942 list price could save about $2,012 (34%).
Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.
Lowest cash prices
| Hospital | Location | Cash | Insurer | CMS rating | ER wait | Readmit |
|---|---|---|---|---|---|---|
| Ringgold County Hospital | Mount Ayr, IA | $598 | — | — | 128 min | — |
| Chase County Community Hospital | Imperial, NE | $605 | $557 | — | 145 min | — |
| Community Memorial Hospital | Cloquet, MN | $613 | $915 | — | 123 min | — |
| Greater Baltimore Medical Center | Baltimore, MD | $614 | $314 | ★ 5/5 | 228 min | — |
| Contra Costa Regional Medical Center | Martinez, CA | $630 | — | ★ 4/5 | 171 min | — |
| Margaret Mary Community Hospital Inc | Batesville, IN | $636 | $314 | — | 132 min | — |
| Island Hospital | Anacortes, WA | $645 | $1,862 | ★ 4/5 | 204 min | — |
| Grand River Hospital District | Rifle, CO | $649 | $2,845 | — | 110 min | — |
| Down East Community Hospital | Machias, ME | $653 | $759 | ★ 4/5 | 195 min | — |
| Samaritan Medical Center | Watertown, NY | $653 | $4,146 | ★ 2/5 | 260 min | — |
| Clifton-Fine Hospital | Star Lake, NY | $653 | $4,146 | — | — | — |
| Harney District Hospital | Burns, OR | $653 | $723 | — | 94 min | — |
| Columbia Memorial Hospital | Astoria, OR | $653 | $303 | — | 123 min | — |
| Mercy Hospital Paris | Paris, AR | $655 | $395 | ★ 5/5 | 118 min | — |
| Jamestown Regional Medical Center | Jamestown, ND | $661 | $650 | ★ 4/5 | 109 min | — |
| Jefferson Regional Medical Center | Pine Bluff, AR | $664 | $3,147 | ★ 1/5 | 198 min | — |
| Altru Hospital | Grand Forks, ND | $671 | $5,176 | ★ 3/5 | 177 min | — |
| Buena Vista Regional Medical Center | Storm Lake, IA | $674 | — | ★ 2/5 | 152 min | — |
| Greater Regional Medical Center | Creston, IA | $680 | — | ★ 3/5 | 101 min | — |
| Carle Health Methodist Hospital | Peoria, IL | $683 | $784 | ★ 2/5 | 213 min | — |
| Trinity Rock Island | Rock Island, IL | $683 | $913 | ★ 3/5 | 172 min | — |
| Unitypoint Health-Marshalltown | Marshalltown, IA | $683 | $674 | ★ 3/5 | 162 min | — |
| Trinity Muscatine | Muscatine, IA | $683 | $812 | ★ 4/5 | 136 min | — |
| Trinity Regional Medical Center | Fort Dodge, IA | $683 | $857 | ★ 2/5 | 167 min | — |
| St Lukes Hospital | Cedar Rapids, IA | $683 | $812 | ★ 4/5 | 166 min | — |
CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.
What insurers pay for Tonsillectomy
Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $3,930; Medicare pays $252.
| Insurer | Hospitals | Negotiated median |
|---|---|---|
| Medicaid | 164 |
$74 – $1,671 |
| Univera | 12 |
$24 – $357 |
| Medicare | 273 |
$109 – $5,936 |
| Independent Health | 21 |
$141 – $1,772 |
| Sanford Health Plan | 27 |
$212 – $5,888 |
| Workers' Comp / No-Fault | 41 |
$662 – $5,381 |
| Priority Health | 32 |
$225 – $5,310 |
| Geisinger | 35 |
$267 – $8,486 |
| UCare | 40 |
$206 – $6,216 |
| AmeriHealth | 125 |
$209 – $9,094 |
| HealthPartners | 103 |
$210 – $7,113 |
| Tricare / VA | 186 |
$138 – $6,864 |
| MVP Health Care | 42 |
$241 – $9,531 |
| Harvard Pilgrim | 22 |
$375 – $7,462 |
| Amerigroup | 115 |
$233 – $3,497 |
| Bright Health | 38 |
$1,348 – $5,466 |
| Medica | 77 |
$271 – $5,806 |
| Molina Healthcare | 397 |
$211 – $5,793 |
| Coventry | 57 |
$304 – $6,484 |
| Centene / Ambetter | 519 |
$225 – $6,539 |
| MultiPlan / PHCS network | 254 |
$328 – $9,391 |
| Highmark | 96 |
$127 – $11,753 |
| Devoted Health | 114 |
$2,844 – $6,348 |
| UPMC Health Plan | 61 |
$508 – $13,201 |
| Healthcare Highways | 33 |
$3,041 – $5,524 |
| Anthem | 388 |
$227 – $9,856 |
| Humana | 647 |
$266 – $7,134 |
| Blue Cross Blue Shield | 844 |
$168 – $12,854 |
| Health Net | 136 |
$161 – $10,661 |
| UnitedHealthcare | 981 |
$289 – $9,414 |
| Kaiser Permanente | 146 |
$194 – $13,697 |
| Aetna | 871 |
$365 – $9,842 |
| SelectHealth | 29 |
$631 – $6,486 |
| Security Health Plan | 23 |
$254 – $12,277 |
| Oscar Health | 148 |
$3,549 – $8,162 |
| Cigna | 689 |
$1,688 – $14,857 |
| EmblemHealth | 51 |
$1,772 – $46,702 |
| AvMed | 28 |
$4,175 – $12,418 |
Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.
Where it’s cheapest
| State | Median cash |
|---|---|
| Vermont | $442 |
| Iowa | $683 |
| Wyoming | $830 |
| Minnesota | $982 |
| New Hampshire | $1,232 |
| Michigan | $1,700 |
Prices by city
Prices by state
Does Medicare cover Tonsillectomy?
Yes — Medicare generally covers Tonsillectomy. It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $252. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $50 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.
General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.
About these prices
Based on prices published by 1475 US hospitals across 52 states, the typical (median) cash price is $3,930, versus a chargemaster (list) price around $5,942, a median insurer-negotiated rate of $4,121, a Medicare rate of about $252. Most cash prices fall between $653 and $13,356 — a wide spread, which is exactly why comparing hospitals pays off.
How to save
- Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
- Compare several nearby hospitals; prices for the same service can differ severalfold.
- Request a written estimate and the billing code (CPT/DRG) before scheduling.
- Use the Medicare benchmark above to judge whether a quote is reasonable.
- If you are uninsured, ask about financial assistance or prompt-pay discounts.
Frequently asked questions
How much does Tonsillectomy cost without insurance?
Does Medicare cover Tonsillectomy?
What does Medicare pay for Tonsillectomy?
Why do Tonsillectomy prices vary between hospitals?
Is the cash price lower than using insurance?
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