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New York rates for HCPCS 42821

Tonsillectomy and adenoidectomy; age 12 or over

Facilitymedian $5,623 · 10th–90th $479$12,0230%10%10th90th$5,623$1.0$10.0$100.0$1.0K$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
$426.58 / $6,165.95 / $12,022.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,897.79 / $14,454.40
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $2,630.27 / $12,302.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $2,511.89 / $50,118.72
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $426.58 / $1,047.13
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,754.40 / $7,762.47
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,981.07 / $9,120.11
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $371.54 / $1,258.93