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Wisconsin rates for HCPCS 42825

Tonsillectomy, primary or secondary; younger than age 12

Facilitymedian $7,586 · 10th–90th $389–$15,8490%5%10th90th$7,586Professionalmedian $380 · 10th–90th $251–$1,3800%10%10th90th$380$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
$346.74 / $1,584.89 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $316.23 / $1,380.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $10,232.93 / $17,378.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $512.86 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $831.76 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $676.08 / $1,148.15
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $398.11 / $4,897.79
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $588.84 / $851.14
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $446.68 / $8,317.64
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $478.63 / $2,041.74
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $562.34 / $1,047.13
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $575.44 / $891.25
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $16,595.87 / $16,595.87
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $1,258.93 / $1,995.26
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,000.00 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $7,585.78 / $9,772.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $389.05 / $1,000.00