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Michigan rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $4,898 · 10th–90th $355–$12,0230%10%10th90th$4,898Professionalmedian $324 · 10th–90th $251–$7590%10%20%10th90th$324$100.0$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
$354.81 / $4,897.79 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $316.23 / $758.58
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $467.74 / $467.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $81.28
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $407.38 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $323.59 / $707.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $3,715.35 / $10,471.29
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $323.59 / $630.96
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,011.87 / $14,791.08
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $323.59 / $457.09