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Pennsylvania rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $6,432.00 / $15,165.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.38 / $344.89 / $1,260.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.51 / $314.51 / $314.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,150.00 / $6,655.85 / $11,048.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.08 / $304.14 / $304.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.00 / $2,019.00 / $8,051.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.42 / $366.16 / $583.69
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.45 / $657.45 / $657.45
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.74 / $461.27 / $597.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,797.09 / $11,561.95 / $22,168.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$768.00 / $6,416.45 / $17,107.98
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.01 / $431.86 / $1,342.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$353.70 / $9,582.02 / $9,582.02
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.00 / $424.60 / $743.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.64 / $1,657.00 / $7,661.29
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.49 / $365.42 / $606.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.00 / $286.00 / $390.20
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.31 / $286.33 / $390.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$825.00 / $2,715.00 / $4,815.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.01 / $337.27 / $544.79