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New York rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $3,981 · 10th–90th $1,622–$8,9130%10%10th90th$3,981Professionalmedian $646 · 10th–90th $65–$6,0260%20%10th90th$646$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
$1,698.24 / $4,073.80 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $1,862.09 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,548.82 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $398.11
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $3,311.31 / $8,128.31
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,344.23 / $4,786.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57