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 |  | With Insurance Coverage: Copays, Coinsurance and Deductibles |  | Without Insurance: Average $5,442 |
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Removal of tonsils -- or tonsillectomy -- is most common in children under age 12, often because of recurring infections. Adults sometimes get tonsillectomies, especially for sleep problems caused by enlarged tonsils.
Typical costs: |
- For those not covered by health insurance, a tonsillectomy -- with or without an adenoidectomy -- typically costs from $4,153 to $6,381, with an average cost of $5,442, according to Blue Cross Blue Shield of North Carolina. For example, a survey by the Minnesota Council of Health Plans found the average cost was $4,875 in that state.
- Most tonsillectomies are covered by health insurance if ordered by a doctor. For example, according to Blue Cross Blue Shield of Kansas[1] , any necessary surgery would be covered, unless it is experimental or covered in a specific exclu
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What should be included: |
- The doctor will conduct a pre-surgery office visit.
- On the day of surgery, the patient is admitted to the hospital, placed under anesthesia and tonsil tissue is surgically removed.
- Post-surgical follow-up visits for one month usually are included.
Additional costs: |
- Antibiotics and pain medications usually are prescribed after a tonsillectomy, according to Texas Pediatric Surgical Associates[2] . A standard prescription copay would apply.
Discounts: |
- According to a Dutch study reported on MedPageToday.com[3] , watchful waiting can be a more cost-effective solution to tonsil problems in some children.
Shopping for tonsil removal: |
- To find a doctor, get a referral from a pediatrician or family physician. Check with the American Board of Otolaryngology to verify that a doctor you are considering is a board-certified head and neck surgeon.
- While tonsillectomies are the most common surgery performed on children in the United States, they are less common than in the past. Tonsils are part of the immune system, which is a consideration when considering a tonsillectomy. The American Academy of Otolaryngology has an overview on tonsils.
- According to the National Institutes of Health[4] , a tonsillectomy should be considered only when: there are seven or more episodes of tonsillitis in a year or five or more per year over two-years; enlarged tonsils that interfere with breathing; an abscess in the tonsils or extremely asymmetric tonsils.
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Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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What People Are Paying - Recent Comments |
| Posted by: Father in Lima, OH. | Posted: September 23rd, 2021 02:09AM |
| Clinic or Doctor: St. Rita's | Insurance Carrier: Anthem Blue Cross |
| Type of Policy: 80/20 |
After Insurance cost to myself 2,071.00 |
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| Posted by: 1Ladylody in Crown point, IN. | Posted: September 9th, 2021 11:09AM |
| Clinic or Doctor: 14000 | Insurance Carrier: Cigna |
| Type of Policy: Private insurance |
After an in network surgeon chose and out of network facility that I didn’t know . He then billed my insurance 14500 for the procedure and the out of network facility billed my insurance 60,000 and the out of network anesthesiologist billed over 7200 for a 30 minute surgery only 12000 was paid to the surgeon and I’m on the hook for the balance. High way robbery. |
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| Posted by: a user in Houston, TX. | Posted: March 8th, 2020 05:03AM |
| Clinic or Doctor: Allergy & ENT Associates | Insurance Carrier: BCBS Kansas City |
| Type of Policy: PPO |
Total of $9519 for the tonsillectomy itself, my part being $2209. In total,the entire process from first appointment, medications, and tests comes to $3237. Not sure how reasonable the price is broken down by cost on the insurances part. I understand people need to get paid, but for the time and effort involved, I agree with other commenters that some of these prices are clearly unreasonable. |
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| Posted by: Support single payer in Kansas city, mo, MO. | Posted: July 1st, 2019 09:07AM |
| Clinic or Doctor: Clinic | Insurance Carrier: Bcbs |
| Type of Policy: Ppo |
Anesthesiologist charge $1000; BCBS paid $361
ENT Surgeon charge $645; BCBS paid $266
Ambulatory Surgery Center charge $19,480; BCBS paid $15,603
I pay $1000/mo for BCBS PPO and my total share of tonsillectomy is $4894.... |
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| Posted by: a user in New York, NY. | Posted: May 23rd, 2019 10:05AM |
| Clinic or Doctor: NYU Langone Hospitals | Insurance Carrier: United Health |
My insurance was billed $80033.68. That's 80K for a 30 min procedure and a total stay at the hospital of 6 hours. If this is not robbery I don't know what is. After insurance payment and adjustments I was left with almost 5K in bills. |
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| Posted by: a user in Rochester, MN. | Posted: January 10th, 2018 02:01PM |
| Clinic or Doctor: Olmsted Medical Center | Insurance Carrier: Blue Cross Blue Shield |
Quoted at $11,000 for surgery. Cost does not include the initial visit w/ an ENT to get the surgery approved, the pre-op consultation, blood work, or post-op visit. After insurance, my out of pocket cost is $2,000. I am floored that it costs so much for a 30-minute procedure. I feel like clinics are out to make money, not help people. I do not qualify for assistance, though they offered to run it just to see. Costs of procedures are increasing, cost of premiums are increasing, yet the standard cost of living increase seems to fall (very) short. |
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| Posted by: Lindser in Westfield, NJ. | Posted: November 16th, 2016 02:11PM |
| Clinic or Doctor: Outpatient Surgery Center | Insurance Carrier: Horizon BCBS |
| Type of Policy: Omnia Silver |
Insurance covered approximately 5k, my copay was $250. Much better than I had expected. Hoping for no more bills, as it's been almost 2 weeks since the procedure. |
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| Posted by: a user in Augusta, SC. | Posted: May 31st, 2016 05:05PM |
| Clinic or Doctor: Doctors Hospital | Insurance Carrier: |
Insurance was billed $26,909.57 for the hospital bill alone. The surgeons fees and anesthesiologist where well within reason. Doctor's Hospital is outrageous!6 months later and I am still trying to get someone to give me a straight answer why. |
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| Posted by: RachCal in Pearland, TX. | Posted: May 5th, 2015 05:05AM |
| Clinic or Doctor: Pearland Medical Center | Insurance Carrier: BCBS TX |
| Type of Policy: PPO |
THIS IS RIDICULOUS. THIS IS 6 SEMESTERS AT A COMMUNITY COLLEGE, A BRAND NEW VEHICLE, HALF A SEMESTER OF CREDITS AT A UNIVERSITY. WTF????? ABSOLUTELY RIDICULOUS. FIRST TAKE ALL MY HARD EARNED MONEY IN TAXES FOR THE NON-WORKING LAZY CLASS NOW THIS. THE DOCTOR PERFORMING THE SURGERY ONLY COST ME 28$ AND 643$ FOR THE ANESTHESIOLOGIST. THIS WAS MARCH OF 2015 NOT 2014 |
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| Posted by: John Welch in Tempe, AZ. | Posted: May 2nd, 2015 04:05AM |
| Type of Policy: No insurance |
I paid 7500 and they grew back. Is this even possible & I'd like to sue |
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| Posted by: a user in toledo, OH. | Posted: April 29th, 2015 10:04AM |
| Type of Policy: Medicaid and self pay |
My son had his tonsils out in August. Last week we got a bill for 1500 more after everyone else paid. I was floored. 15 thousand dollars?!?!?!? Why does mercy need to charge that much? |
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| Posted by: NW ENT DOC in Woodstock, GA. | Posted: December 11th, 2013 05:12AM |
| Clinic or Doctor: Northwest ENT and Allergy Center | Insurance Carrier: None |
| Type of Policy: None |
This surgery center was able to offer a unique all inclusive cash price option for ENT surgery. Cash pricing gives those with no insurance or anyone choosing not to use insurance a reasonably priced option for outpatient surgery. |
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| Posted by: Private in dfw, TX. | Posted: September 1st, 2013 05:09AM |
| Clinic or Doctor: North Texas | Insurance Carrier: BC |
| Type of Policy: PPO |
Doctor fee was around $700 with the remaining fee of $10,300 coming from the hospital. |
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| Posted by: KylamC in Aiken, SC. | Posted: August 26th, 2013 08:08PM |
| Type of Policy: Medicaid |
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| Posted by: jmcn in Ankeny, IA. | Posted: March 13th, 2013 08:03PM |
| Clinic or Doctor: Mercy in Ankeny, IA | Insurance Carrier: BCBS |
| Type of Policy: ppo |
Complete BS for a 20 min procedure |
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| Posted by: bigdee in metrodetroit, MI. | Posted: January 10th, 2013 11:01AM |
| Clinic or Doctor: detroit medical center | Insurance Carrier: blue cross blue shield |
| Type of Policy: ppo |
Wow I wished I got it done arlt an ambulatory surgery center. Hospial and anasteeshea outrageous but surgeons fees were reasonble. Makes you wonder if you are paying through the nose a t their suburban clinics if you have insurance to pay for their innercity teaching hospital center mess. GO stuck payiing 20 percent on own. |
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External Resources: |
- www.bcbsks.com/
- www.pedisurg.com/PtEducENT/Post-tonsillectomy.htm
- www.medpagetoday.com/Surgery/Otolaryngology/7446
- www.nlm.nih.gov/medlineplus/ency/article/003013.htm
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