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Pennsylvania rates for HCPCS 42835

Adenoidectomy, secondary; younger than age 12

Facilitymedian $5,129 · 10th–90th $1,288–$8,5110%10%10th90th$5,129Professionalmedian $224 · 10th–90th $174–$4570%20%10th90th$224$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
$1,412.54 / $5,248.07 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $213.80 / $457.09
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $7,585.78 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $2,089.30 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $239.88 / $398.11
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $416.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $380.19
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
$177.83 / $208.93 / $323.59
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $11,220.18 / $19,498.45
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $4,265.80 / $8,511.38
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $794.33
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $331.13 / $457.09
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $691.83
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $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
$158.49 / $213.80 / $363.08