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Ohio rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $3,020 · 10th–90th $1,122$10,7150%10%10th90th$3,020Professionalmedian $1,950 · 10th–90th $0$10,2330%5%10%10th90th$1,950$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
$1,698.24 / $3,019.95 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $2,454.71 / $11,481.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $7,244.36 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.02 / $0.02 / $0.03
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $316.23 / $2,398.83
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $575.44 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $562.34 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $33.11 / $60.26
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $144.54
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $70.79 / $75.86
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $707.95 / $2,818.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $69.18 / $83.18