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West Virginia rates for HCPCS 42820

Tonsillectomy and adenoidectomy; younger than age 12

Facilitymedian $6,026 · 10th–90th $501–$9,7720%10%10th90th$6,026Professionalmedian $407 · 10th–90th $269–$6310%10%10th90th$407$100.0$500.0$2.0K$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
$3,715.35 / $6,606.93 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $407.38 / $630.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $354.81 / $501.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $331.13 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $398.11 / $1,862.09
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,244.36 / $18,620.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,388.44 / $16,595.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $478.63