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North Carolina rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $4,571 · 10th–90th $331$8,3180%10%10th90th$4,571Professionalmedian $468 · 10th–90th $282$1,0000%10%20%10th90th$468$1.0$10.0$100.0$1.0K$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
$426.58 / $5,495.41 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $467.74 / $1,258.93
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $407.38 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,819.70 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $467.74 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $3,019.95 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $416.87 / $707.95
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $371.54 / $588.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $741.31
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $15,848.93
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $371.54 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $4,897.79 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $323.59 / $575.44
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $45,708.82
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,691.53 / $2,691.53