go back

Massachusetts rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $2,239 · 10th–90th $724–$5,1290%10%10th90th$2,239Professionalmedian $2,818 · 10th–90th $151–$4,3650%20%10th90th$2,818$0.1$0.5$5.0$50.0$500.0$5.0K$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
$1,318.26 / $2,344.23 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $2,818.38 / $4,365.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $407.38 / $2,754.23
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $199.53 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $676.08 / $741.31
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $3,311.31 / $8,511.38
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $1,819.70 / $3,467.37
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $562.34
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.03 / $407.38 / $2,754.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $199.53 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $1,000.00 / $2,754.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $64.57 / $162.18