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New York rates for HCPCS 42831

Adenoidectomy, primary; age 12 or over

Facilitymedian $4,786 · 10th–90th $363$10,9650%5%10th90th$4,786$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
$316.23 / $5,248.07 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $2,398.83 / $10,964.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $2,290.87 / $50,118.72
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $812.83
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $5,623.41 / $6,165.95
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,981.07 / $9,120.11
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $281.84 / $891.25