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Maryland rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $3,548 · 10th–90th $603–$5,1290%10%20%10th90th$3,548Professionalmedian $490 · 10th–90th $282–$2,4550%10%10th90th$490$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
$398.11 / $3,890.45 / $5,128.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $537.03 / $2,630.27
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $309.03 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $3,090.30 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $562.34
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $302.00 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $1,202.26 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $331.13 / $562.34
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $316.23 / $389.05