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New York rates for HCPCS 42836

Adenoidectomy, secondary; age 12 or over

Facilitymedian $4,467 · 10th–90th $389–$10,9650%5%10th90th$4,467Professionalmedian $309 · 10th–90th $214–$7410%10%10th90th$309$100.0$500.0$2.0K$10.0K$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
$338.84 / $4,168.69 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $281.84 / $676.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $4,786.30 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $229.09 / $478.63
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $2,398.83 / $10,964.78
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $2,290.87 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $389.05 / $870.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $338.84 / $851.14
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $338.84 / $501.19
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $288.40 / $524.81
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $398.11 / $660.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,981.07 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $398.11 / $2,630.27
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $295.12 / $1,000.00
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $295.12 / $645.65