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North Carolina rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $2,344 · 10th–90th $275$8,7100%10%20%10th90th$2,344Professionalmedian $407 · 10th–90th $263$8320%10%20%10th90th$407$1.0$5.0$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
$389.05 / $4,786.30 / $8,709.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $363.08 / $1,047.13
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,819.70 / $2,041.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $407.38 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $3,388.44 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $380.19 / $645.65
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $537.03
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $676.08
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $331.13 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $4,897.79 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $288.40 / $524.81
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $16,982.44 / $33,884.42
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,290.87