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Washington rates for HCPCS 42999

Unlisted procedure, pharynx, adenoids, or tonsils

Facilitymedian $1,905 · 10th–90th $339–$17,7830%5%10%10th90th$1,905Professionalmedian $1,175 · 10th–90th $50–$4,3650%10%10th90th$1,175$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
$524.81 / $4,466.84 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $1,174.90 / $4,365.16
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $645.65 / $1,318.26
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $707.95 / $954.99
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $562.34 / $954.99
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $50.12 / $64.57
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $588.84 / $588.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$426.58 / $676.08 / $1,318.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $141.25 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $794.33 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57