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Pennsylvania rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $5,754 · 10th–90th $1,023$10,4710%5%10%10th90th$5,754$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$50.0K

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
$1,023.29 / $5,754.40 / $10,471.29
Aetna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $4,168.69
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $8,912.51 / $8,912.51
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,606.93 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $1,995.26 / $3,715.35
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
$524.81 / $524.81 / $524.81
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,137.96 / $2,570.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $7,244.36 / $13,803.84
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $8,912.51 / $8,912.51
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $4,265.80 / $10,000.00
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $5,370.32 / $6,918.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,311.31 / $10,715.19