go back

Wisconsin rates for HCPCS 42826

Tonsillectomy, primary or secondary; age 12 or over

Facilitymedian $5,248 · 10th–90th $550–$10,0000%10%20%10th90th$5,248Professionalmedian $550 · 10th–90th $302–$9330%20%10th90th$550$1.0$5.0$20.0$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
$537.03 / $6,025.60 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,786.30 / $7,585.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $794.33 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $389.05 / $5,888.44
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $512.86 / $7,943.28
Medica
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$6,025.60 / $6,025.60 / $6,025.60
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $5,754.40 / $7,762.47
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $549.54 / $851.14
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $7,943.28 / $7,943.28
Quartz
Facility/Professional
Facility
Modifier
52
Typical Low / Median / Typical High
$346.74 / $4,265.80 / $6,309.57
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,585.78 / $9,120.11