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Repeat Adenoid Removal, Age 12+

Wisconsin rates for HCPCS 42836

This procedure removes adenoid tissue, glands located behind the nose above the throat, that has regrown or was left behind after an earlier removal. It is performed in a patient who is at least 12 years old. It is typically done when the adenoid tissue causes ongoing nasal blockage, breathing problems during sleep, or repeated ear or sinus infections despite a prior removal.

Rates data updated July 2026.

Facilitymedian $4,571 · 10th–90th $331$7,7620%10%10th90th$4,571Professionalmedian $372 · 10th–90th $234$1,0720%10%10th90th$372$50.0$200.0$1.0K$5.0K

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
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$4,073.80
Typical High
$8,317.64
Aetna
Setting
Professional
Modifier
Global
Typical Low
$223.87
Median
$275.42
Typical High
$933.25
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,311.31
Median
$4,897.79
Typical High
$7,585.78
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$467.74
Typical High
$1,202.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$758.58
Typical High
$1,230.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$645.65
Typical High
$1,047.13
DeanCare
Setting
Facility
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$5,888.44
DeanCare
Setting
Professional
Modifier
Global
Typical Low
$436.52
Median
$537.03
Typical High
$776.25
Medica
Setting
Facility
Modifier
Global
Typical Low
$239.88
Median
$380.19
Typical High
$7,943.28
Medica
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$436.52
Typical High
$1,862.09
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$70.79
Network Health
Setting
Facility
Modifier
Global
Typical Low
$489.78
Median
$5,754.40
Typical High
$7,762.47
Network Health
Setting
Professional
Modifier
Global
Typical Low
$275.42
Median
$537.03
Typical High
$954.99
Prevea360
Setting
Facility
Modifier
Global
Typical Low
$229.09
Median
$316.23
Typical High
$501.19
Quartz
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$524.81
Typical High
$812.83
Quartz
Setting
Facility
Modifier
Global
Typical Low
$416.87
Median
$8,317.64
Typical High
$8,317.64
Quartz
Setting
Professional
Modifier
Global
Typical Low
$263.03
Median
$1,148.15
Typical High
$1,819.70
Security Health
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Security Health
Setting
Professional
Modifier
Global
Typical Low
$501.19
Median
$933.25
Typical High
$1,258.93
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$7,244.36
Typical High
$8,912.51
United
Setting
Professional
Modifier
Global
Typical Low
$234.42
Median
$354.81
Typical High
$954.99