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Virginia rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $2,344 · 10th–90th $282–$9,1200%5%10%10th90th$2,344Professionalmedian $316 · 10th–90th $234–$5500%10%10th90th$316$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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 / $3,981.07 / $9,549.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,090.30 / $3,981.07 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,412.54 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $269.15 / $549.54
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $380.19 / $549.54
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $524.81
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $316.23 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $5,495.41 / $12,882.50