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Iowa rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $4,365 · 10th–90th $339–$10,9650%10%10th90th$4,365Professionalmedian $407 · 10th–90th $257–$1,0960%20%10th90th$407$10.0$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
$457.09 / $4,786.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $389.05 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $630.96 / $794.33
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $562.34 / $1,202.26
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $588.84 / $14,454.40
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $489.78 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $602.56 / $724.44
Midlands
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,244.36 / $7,244.36 / $7,244.36
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $524.81 / $724.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $537.03 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $7,762.47 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $380.19 / $707.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $524.81 / $616.60