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Illinois rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $5,129 · 10th–90th $724–$8,9130%10%10th90th$5,129Professionalmedian $372 · 10th–90th $257–$8910%10%10th90th$372$20.0$100.0$500.0$2.0K$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
$691.83 / $5,128.61 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $891.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $7,413.10 / $10,232.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $371.54 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $363.08 / $588.84
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $478.63 / $1,513.56
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $338.84 / $371.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $4,570.88 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $331.13 / $537.03