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New Mexico rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $417 · 10th–90th $282–$9,3330%10%20%10th90th$417Professionalmedian $302 · 10th–90th $251–$8320%10%20%10th90th$302$50.0$200.0$1.0K$5.0K$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
$371.54 / $389.05 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $295.12 / $1,096.48
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $8,709.64 / $13,803.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $323.59 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $478.63
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $389.05
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $354.81 / $588.84
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $602.56
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $6,606.93 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $371.54 / $575.44