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New York rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $5,370 · 10th–90th $407–$10,4710%5%10%10th90th$5,370$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
$354.81 / $5,888.44 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $2,398.83 / $10,964.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $2,290.87 / $50,118.72
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $354.81 / $891.25
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $6,760.83 / $7,762.47
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,981.07 / $9,120.11
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $309.03 / $1,023.29