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Virginia rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $2,042 · 10th–90th $295–$8,5110%5%10th90th$2,042Professionalmedian $324 · 10th–90th $251–$6310%10%10th90th$324$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
$363.08 / $3,981.07 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $316.23 / $758.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $346.74 / $537.03
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $302.00 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $2,951.21 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $512.86
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $588.84
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $389.05 / $549.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $354.81 / $549.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $602.56
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $323.59 / $1,258.93
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $323.59 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $5,495.41 / $12,882.50
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $512.86