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California rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $8,511 · 10th–90th $1,820–$16,9820%5%10%10th90th$8,511Professionalmedian $275 · 10th–90th $214–$5750%10%20%10th90th$275$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
$2,818.38 / $7,413.10 / $17,782.79
Aetna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$9,120.11 / $9,120.11 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $10,471.29 / $17,782.79
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $6,165.95 / $12,589.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,698.24 / $3,548.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $371.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $275.42 / $588.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $33,884.42
Lucent Health
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $338.84 / $562.34
Sutter Health Plus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $7,079.46 / $14,454.40