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Pennsylvania rates for HCPCS 42831

Adenoidectomy, primary; age 12 or over

Facilitymedian $4,786 · 10th–90th $537–$9,1200%5%10%10th90th$4,786$500.0$1.0K$2.0K$5.0K$10.0K$20.0K$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
$537.03 / $5,011.87 / $9,120.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $6,606.93 / $57,543.99
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $1,995.26 / $3,890.45
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $478.63
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,089.30 / $2,570.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $6,456.54 / $18,197.01
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $3,801.89 / $8,511.38
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $302.00 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,311.31 / $10,715.19