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Wisconsin rates for HCPCS 42821

Tonsillectomy and adenoidectomy; age 12 or over

Facilitymedian $4,571 · 10th–90th $603–$7,9430%10%10th90th$4,571Professionalmedian $646 · 10th–90th $355–$1,0960%10%20%10th90th$646$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $3,981.07 / $8,511.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,897.79 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $933.25 / $1,513.56
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $6,309.57
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $602.56 / $7,943.28
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $5,754.40 / $7,762.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $645.65 / $1,000.00
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $7,943.28 / $7,943.28
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,585.78 / $9,120.11