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Ohio rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $5,888 · 10th–90th $794$11,7490%10%10th90th$5,888$100.0$500.0$2.0K$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
$478.63 / $6,760.83 / $12,022.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $2,754.23 / $7,244.36
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $275.42 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $436.52 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $3,311.31 / $7,585.78
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $4,073.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $4,168.69 / $7,943.28