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New Jersey rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $6,918 · 10th–90th $4,467–$11,2200%10%20%10th90th$6,918Professionalmedian $316 · 10th–90th $240–$7590%10%20%10th90th$316$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$4,466.84 / $6,918.31 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $316.23 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $354.81 / $724.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $346.74 / $501.19
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $19,054.61 / $30,199.52
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $302.00 / $645.65
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $6,165.95 / $10,471.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $302.00 / $549.54