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Illinois rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $5,495 · 10th–90th $724–$9,5500%5%10th90th$5,495Professionalmedian $457 · 10th–90th $282–$1,3490%5%10%10th90th$457$50.0$200.0$1.0K$5.0K$20.0K

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
$660.69 / $5,495.41 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $489.78 / $1,548.82
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $302.00 / $407.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $7,413.10 / $10,232.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $354.81 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $588.84 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $398.11 / $630.96
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $512.86 / $1,698.24
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $371.54 / $407.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $363.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,570.88 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $363.08 / $602.56