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New Jersey rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $6,761 · 10th–90th $2,951–$10,7150%10%20%10th90th$6,761Professionalmedian $389 · 10th–90th $269–$1,5140%10%10th90th$389$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
$2,951.21 / $6,760.83 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $407.38 / $3,630.78
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $295.12 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $758.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $371.54 / $562.34
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $331.13 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $6,165.95 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $331.13 / $645.65