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Repeat Removal Of Adenoid Tissue In A Child

Washington, DC rates for HCPCS 42835

This procedure removes adenoid tissue that has regrown or was not completely removed during an earlier surgery, in a patient younger than 12. The adenoids are tissue at the back of the nasal passage that can contribute to nasal blockage, snoring, or recurrent infections when enlarged.

Rates data updated July 2026.

How much does Repeat Removal Of Adenoid Tissue In A Child cost?

$224

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $224 for this service. Most negotiated rates run $204 to $288.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,623 · 10th to 90th $537 to $7,762Professionalmedian $219 · 10th to 90th $170 to $269
$200$500$1K$2K$5K$10K$20Kfacility $5,623professional $219

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$537.03
Median
$5,623.41
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$173.78
Median
$218.78
Typical High
$239.88
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$190.55
Median
$213.80
Typical High
$3,548.13
Cigna
Setting
Professional
Modifier
Global
Typical Low
$165.96
Median
$245.47
Typical High
$562.34
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$204.17
Typical High
$398.11
United
Setting
Facility
Modifier
Global
Typical Low
$1,819.70
Median
$10,000.00
Typical High
$26,302.68
United
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$223.87
Typical High
$501.19

Where Washington, DC sits

The same service costs 2.8 times more in California than in Vermont. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 38th of 51

$224

CA $562VT $200

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.