Tonsillectomy Cost by Hospital

Tonsillectomy is a surgical procedure. Prices are from 1462 US hospitals across 52 states, from their machine-readable files.

$3,857median cash price · 1462 hospitals, 52 statestypically $653–$13,273 depending on the hospital
≈ 15.3× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$5,631
Cash / self-pay
$3,857
Insurer-negotiated
$4,121
Medicare pays
$252
$653$13,273
Median cash $3,857  ·  Medicare $252  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $3,857 — about 15.3× 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 $5,631 list price could save about $1,774 (31%).

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
St Joseph's Hospital Health Center Syracuse, NY $584 $122 ★ 2/5 228 min 16.2%
Bellville Medical Center Bellville, TX $584 $122 — 101 min 15.6%
Chase County Community Hospital Imperial, NE $592 $557 — 131 min 15.5%
Ringgold County Hospital Mount Ayr, IA $598 — — 140 min 14.7%
Community Memorial Hospital Cloquet, MN $613 $915 — 128 min 15.2%
Greater Baltimore Medical Center Baltimore, MD $614 $314 ★ 5/5 231 min 13.5%
Contra Costa Regional Medical Center Martinez, CA $630 — ★ 4/5 175 min 14.2%
Margaret Mary Community Hospital Inc Batesville, IN $636 $314 — 132 min 15.1%
Island Hospital Anacortes, WA $645 $1,862 ★ 4/5 193 min 14.8%
Grand River Hospital District Rifle, CO $649 $2,845 — 107 min 14.4%
Down East Community Hospital Machias, ME $653 $737 ★ 4/5 189 min 14.7%
Samaritan Medical Center Watertown, NY $653 $4,146 ★ 2/5 260 min 15.3%
Clifton-Fine Hospital Star Lake, NY $653 $4,146 — — —
Harney District Hospital Burns, OR $653 $723 — 93 min 15.6%
Columbia Memorial Hospital Astoria, OR $653 $303 — 132 min —
Mercy Hospital Paris Paris, AR $655 $395 ★ 5/5 117 min 14.4%
Jamestown Regional Medical Center Jamestown, ND $661 $650 ★ 4/5 110 min 14.7%
Jefferson Regional Medical Center Pine Bluff, AR $664 $3,147 ★ 1/5 200 min 15.3%
Altru Hospital Grand Forks, ND $671 $5,176 ★ 3/5 167 min 13.9%
Buena Vista Regional Medical Center Storm Lake, IA $674 — ★ 2/5 151 min 15.0%
Greater Regional Medical Center Creston, IA $680 — ★ 3/5 98 min 14.5%
Carle Health Methodist Hospital Peoria, IL $683 $784 ★ 2/5 220 min 14.7%
Trinity Rock Island Rock Island, IL $683 $913 ★ 3/5 172 min 15.4%
Unitypoint Health-Marshalltown Marshalltown, IA $683 $674 ★ 3/5 154 min 15.2%
Trinity Muscatine Muscatine, IA $683 $812 ★ 4/5 135 min 13.9%

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 August 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: $3,857; Medicare pays $252.

InsurerHospitalsNegotiated median
Medicaid 162
$127
$74 – $1,671
Univera 12
$225
$24 – $357
Medicare 269
$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
Geisinger 32
$1,110
$267 – $7,060
UCare 40
$1,114
$206 – $6,216
Priority Health 33
$1,117
$225 – $5,310
AmeriHealth 122
$1,155
$209 – $9,094
Tricare / VA 184
$1,168
$138 – $6,864
HealthPartners 101
$1,181
$210 – $7,122
MVP Health Care 43
$1,772
$241 – $9,531
Medica 78
$1,901
$273 – $5,806
Amerigroup 114
$1,954
$231 – $3,497
Harvard Pilgrim 22
$1,957
$390 – $7,462
Bright Health 38
$2,007
$1,348 – $5,466
Molina Healthcare 395
$2,189
$211 – $5,882
Centene / Ambetter 503
$2,302
$221 – $6,539
Coventry 55
$2,384
$297 – $7,539
Highmark 88
$2,930
$124 – $11,744
MultiPlan / PHCS network 243
$2,966
$331 – $9,391
Devoted Health 110
$3,567
$2,479 – $6,344
UPMC Health Plan 56
$3,576
$508 – $10,508
Healthcare Highways 33
$3,650
$3,041 – $5,524
Anthem 373
$3,697
$215 – $10,052
Humana 637
$3,738
$268 – $7,133
Blue Cross Blue Shield 844
$3,763
$168 – $12,665
Health Net 134
$3,814
$160 – $10,661
UnitedHealthcare 962
$4,094
$286 – $9,445
Kaiser Permanente 146
$4,118
$194 – $13,684
Aetna 851
$4,291
$395 – $9,842
SelectHealth 29
$4,882
$631 – $6,486
Security Health Plan 23
$5,205
$254 – $12,277
Oscar Health 135
$5,926
$3,549 – $8,162
Cigna 667
$6,084
$1,847 – $14,857
AvMed 28
$8,253
$4,175 – $12,418
EmblemHealth 37
$12,590
$1,772 – $46,702

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
Iowa$683
Wyoming$830
Vermont$866
Minnesota$982
New Hampshire$1,232
Michigan$1,700

Prices by city

Chicago, ILAustin, TXFort Worth, TXDallas, TXHouston, TXLos Angeles, CANew York, NYSacramento, CASan Antonio, TXBrooklyn, NYCharlotte, NCCincinnati, OHCleveland, OHPhiladelphia, PAPittsburgh, PAPlano, TXArlington, TXBronx, NYKansas City, MOLittle Rock, ARMilwaukee, WINashville, TNOmaha, NERochester, NY

Prices by state

TexasCaliforniaOhioWisconsinFloridaNew YorkMinnesotaPennsylvaniaIllinoisColoradoNorth CarolinaMichiganLouisianaTennesseeNew JerseyIowaNebraskaMissouriIndianaWashingtonKansasArkansasMississippiArizonaVirginiaGeorgiaMaineSouth CarolinaOklahomaIdahoMassachusettsKentuckyAlabamaUtahWest VirginiaConnecticutOregonNew MexicoNew HampshireSouth DakotaWyomingNevadaNorth DakotaMontanaVermontPuerto RicoMarylandDelawareAlaska

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 1462 US hospitals across 52 states, the typical (median) cash price is $3,857, versus a chargemaster (list) price around $5,631, a median insurer-negotiated rate of $4,121, a Medicare rate of about $252. Most cash prices fall between $653 and $13,273 — 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 1462 US hospitals is $3,857. Most hospitals fall between $653 and $13,273. 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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