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Maine rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $7,079 · 10th–90th $4,074–$14,1250%10%20%10th90th$7,079Professionalmedian $427 · 10th–90th $288–$8910%10%10th90th$427$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$4,073.80 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $426.58 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $446.68 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $416.87 / $691.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $426.58 / $741.31
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $371.54 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $416.87 / $831.76