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South Dakota rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $2,512 · 10th–90th $257–$6,0260%20%10th90th$2,512Professionalmedian $380 · 10th–90th $257–$3,8020%10%20%10th90th$380$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
$257.04 / $2,511.89 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $6,456.54
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $630.96 / $794.33
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $436.52 / $1,258.93
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $416.87 / $2,041.74
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $436.52 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $416.87 / $724.44
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $645.65 / $645.65