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California rates for HCPCS 42821

Tonsillectomy and adenoidectomy; age 12 or over

Facilitymedian $8,710 · 10th–90th $1,820–$17,7830%5%10%10th90th$8,710Professionalmedian $316 · 10th–90th $245–$7080%20%10th90th$316$50.0$200.0$1.0K$5.0K$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
$3,548.13 / $8,128.31 / $19,952.62
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $10,471.29 / $17,782.79
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $6,918.31 / $14,454.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,659.59 / $3,548.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $426.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $316.23 / $707.95
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $42,657.95
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $398.11 / $660.69
Sutter Health Plus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $7,079.46 / $14,454.40