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Pennsylvania rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $2,692 · 10th–90th $525–$7,7620%10%10th90th$2,692Professionalmedian $2,818 · 10th–90th $295–$64,5650%20%10th90th$2,818$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
$537.03 / $3,235.94 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $851.14 / $4,365.16
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,258.93 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54,954.09 / $64,565.42 / $64,565.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $562.34 / $870.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $537.03 / $851.14
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $251.19
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $2,089.30 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $660.69 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $575.44 / $3,019.95
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57