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South Dakota rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $5,012 · 10th–90th $2,512–$7,0790%10%10th90th$5,012Professionalmedian $617 · 10th–90th $282–$4,5710%10%10th90th$617$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
$2,570.40 / $5,011.87 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $616.60 / $6,606.93
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $588.84 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$489.78 / $676.08 / $851.14
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $524.81 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $457.09 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $660.69 / $660.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $446.68 / $794.33
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $691.83 / $691.83