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Montana rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $468 · 10th–90th $316–$9330%50%10th90th$468Professionalmedian $398 · 10th–90th $257–$3,6310%20%10th90th$398$100.0$500.0$2.0K$10.0K$50.0K

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
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $3,630.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $426.58 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $831.76
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $467.74 / $537.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $467.74 / $537.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $660.69
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $426.58 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $426.58 / $575.44