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Pennsylvania rates for HCPCS 42830

Adenoidectomy, primary; younger than age 12

Facilitymedian $5,012 · 10th–90th $813–$11,7490%5%10%10th90th$5,012Professionalmedian $316 · 10th–90th $204–$8320%20%10th90th$316$10.0$50.0$200.0$1.0K$5.0K$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
$831.76 / $5,011.87 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $316.23 / $870.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $177.83 / $186.21
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,606.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $1,995.26 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $257.04 / $436.52
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $446.68
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $281.84 / $407.38
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,137.96 / $2,511.89
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $223.87 / $346.74
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $7,762.47 / $14,454.40
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $295.12
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $4,265.80 / $10,471.29
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $275.42 / $616.60
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $229.09
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $371.54 / $489.78
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $269.15 / $691.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $269.15 / $691.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,311.31 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $229.09 / $389.05