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Tonsil and Adenoid Removal, Under Age 12

Vermont rates for HCPCS 42820

This surgery removes both the tonsils and adenoids, tissues at the back of the throat and behind the nose that can become chronically infected or enlarged enough to block breathing or cause repeated infections. This version applies to children younger than 12 years old. It's one of the most common surgeries performed on children.

Facilitymedian $7,413 · 10th–90th $2,089$8,7100%20%10th90th$7,413Professionalmedian $347 · 10th–90th $282$6310%20%10th90th$347$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$7,413.10
Median
$7,413.10
Typical High
$8,709.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$281.84
Median
$338.84
Typical High
$630.96
BCBS
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,089.30
Typical High
$2,630.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$407.38
Typical High
$645.65
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$302.00
Median
$416.87
Typical High
$741.31
United
Setting
Professional
Modifier
Global
Typical Low
$316.23
Median
$407.38
Typical High
$645.65