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Michigan rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $4,898 · 10th–90th $1,585–$10,4710%10%10th90th$4,898Professionalmedian $427 · 10th–90th $282–$1,3490%10%10th90th$427$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
$1,995.26 / $4,897.79 / $10,471.29
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
$257.04 / $302.00 / $537.03
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $446.68 / $457.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $354.81 / $501.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $758.58
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $4,677.35 / $9,772.37
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $380.19 / $812.83
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $323.59 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,011.87 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $501.19