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California rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $4,898 · 10th–90th $776–$15,1360%5%10%10th90th$4,898Professionalmedian $1,175 · 10th–90th $58–$5,0120%5%10%10th90th$1,175$0.0$0.2$2.0$20.0$200.0$2.0K$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
$1,584.89 / $5,888.44 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$467.74 / $1,778.28 / $6,025.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $6,760.83 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $190.55 / $190.55
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $3,467.37 / $6,760.83
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $60.26 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $707.95 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $724.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $398.11 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $2,089.30
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $676.08 / $1,023.29
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,513.56 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $64.57 / $64.57