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Delaware rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $5,012 · 10th–90th $2,512–$6,4570%20%10th90th$5,012Professionalmedian $302 · 10th–90th $245–$6920%10%20%10th90th$302$200.0$500.0$1.0K$2.0K$5.0K

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
$2,511.89 / $5,011.87 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $316.23 / $501.19
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,023.29 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $275.42 / $467.74