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Kentucky rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $3,981 · 10th–90th $457–$9,1200%5%10th90th$3,981Professionalmedian $407 · 10th–90th $275–$1,2590%10%20%10th90th$407$50.0$200.0$1.0K$5.0K

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
$436.52 / $3,388.44 / $8,128.31
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $436.52 / $1,348.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $338.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $5,128.61 / $10,715.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $295.12 / $416.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $346.74 / $457.09
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $338.84 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $398.11 / $1,862.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $3,388.44 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $537.03