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Delaware rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $5,012 · 10th–90th $269–$7,4130%10%10th90th$5,012Professionalmedian $407 · 10th–90th $275–$8320%10%10th90th$407$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $5,011.87 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $426.58 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $346.74 / $537.03
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,585.78 / $12,882.50
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,023.29 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $302.00 / $489.78