Tonsillectomy Cost by Hospital

Tonsillectomy is a surgical procedure. Prices are from 1475 US hospitals across 52 states, from their machine-readable files.

$3,930median cash price · 1475 hospitals, 52 statestypically $653–$13,356 depending on the hospital
≈ 15.6× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$5,942
Cash / self-pay
$3,930
Insurer-negotiated
$4,121
Medicare pays
$252
$653$13,356
Median cash $3,930  ·  Medicare $252  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

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%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
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.

InsurerHospitalsNegotiated median
Medicaid 164
$127
$74 – $1,671
Univera 12
$225
$24 – $357
Medicare 273
$260
$109 – $5,936
Independent Health 21
$311
$141 – $1,772
Sanford Health Plan 27
$553
$212 – $5,888
Workers' Comp / No-Fault 41
$699
$662 – $5,381
Priority Health 32
$852
$225 – $5,310
Geisinger 35
$1,110
$267 – $8,486
UCare 40
$1,114
$206 – $6,216
AmeriHealth 125
$1,155
$209 – $9,094
HealthPartners 103
$1,225
$210 – $7,113
Tricare / VA 186
$1,250
$138 – $6,864
MVP Health Care 42
$1,772
$241 – $9,531
Harvard Pilgrim 22
$1,925
$375 – $7,462
Amerigroup 115
$1,954
$233 – $3,497
Bright Health 38
$2,007
$1,348 – $5,466
Medica 77
$2,183
$271 – $5,806
Molina Healthcare 397
$2,189
$211 – $5,793
Coventry 57
$2,222
$304 – $6,484
Centene / Ambetter 519
$2,302
$225 – $6,539
MultiPlan / PHCS network 254
$2,790
$328 – $9,391
Highmark 96
$2,889
$127 – $11,753
Devoted Health 114
$3,580
$2,844 – $6,348
UPMC Health Plan 61
$3,619
$508 – $13,201
Healthcare Highways 33
$3,650
$3,041 – $5,524
Anthem 388
$3,687
$227 – $9,856
Humana 647
$3,738
$266 – $7,134
Blue Cross Blue Shield 844
$3,786
$168 – $12,854
Health Net 136
$3,980
$161 – $10,661
UnitedHealthcare 981
$4,036
$289 – $9,414
Kaiser Permanente 146
$4,118
$194 – $13,697
Aetna 871
$4,264
$365 – $9,842
SelectHealth 29
$4,882
$631 – $6,486
Security Health Plan 23
$5,205
$254 – $12,277
Oscar Health 148
$5,926
$3,549 – $8,162
Cigna 689
$6,084
$1,688 – $14,857
EmblemHealth 51
$7,277
$1,772 – $46,702
AvMed 28
$8,253
$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

StateMedian 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?
The median cash (self-pay) price across 1475 US hospitals is $3,930. Most hospitals fall between $653 and $13,356. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Tonsillectomy?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $252). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Tonsillectomy?
Medicare pays about $252. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Tonsillectomy prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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