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Virginia rates for HCPCS 42821

Tonsillectomy and adenoidectomy; age 12 or over

Facilitymedian $3,236 · 10th–90th $339–$9,3330%5%10th90th$3,236Professionalmedian $372 · 10th–90th $269–$6460%10%10th90th$372$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$416.87 / $4,897.79 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,412.54 / $1,584.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $645.65
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $467.74 / $660.69
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $407.38 / $616.60
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $380.19 / $1,445.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $5,495.41 / $12,882.50