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New York rates for HCPCS 42830

Adenoidectomy, primary; younger than age 12

Facilitymedian $5,129 · 10th–90th $398–$10,2330%5%10%10th90th$5,129Professionalmedian $288 · 10th–90th $191–$7760%10%10th90th$288$100.0$500.0$2.0K$10.0K$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
$302.00 / $5,754.40 / $10,471.29
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $295.12 / $812.83
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $186.21 / $208.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,677.35 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $194.98 / $416.87
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $2,398.83 / $10,964.78
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $2,290.87 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $338.84 / $794.33
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $269.15 / $758.58
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $295.12 / $446.68
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $457.09
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $4,365.16 / $5,888.44
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $380.19 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,981.07 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $338.84 / $1,905.46
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $831.76
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $257.04 / $549.54