Tonsil removal surgery for patients aged 12 and over

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB Tonsillectomy Primary/Secondary Age 12/>

Payers reporting CPT 42826

69 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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1	UnitedHealthcare fee schedule · outpatient · +33 other terms	572	$3,222	$3,654	$46.95 – $95,303
2	Aetna fee schedule · outpatient · +29 other terms	512	$3,583	$4,470	$19.59 – $47,967
3	Humana fee schedule · outpatient · +25 other terms	397	$3,219	$2,852	$1.00 – $16,666
4	Blue Cross Blue Shield fee schedule · outpatient · +31 other terms	392	$4,262	$5,586	$1.00 – $41,400
5	Cigna case rate · outpatient · +25 other terms	351	$6,802	$8,078	$82.00 – $40,673
6	Molina fee schedule · outpatient · +23 other terms	237	$2,385	$1,964	$1.00 – $9,189
7	WellCare fee schedule · outpatient · +15 other terms	195	$3,430	$3,421	$222.46 – $7,600
8	Oscar case rate · outpatient · +18 other terms	136	$5,632	$5,309	$2,399 – $10,148
9	Anthem fee schedule · outpatient · +22 other terms	133	$2,242	$3,037	$122.40 – $24,261
10	Kaiser fee schedule · outpatient · +17 other terms	99	$4,121	$4,669	$36.00 – $22,376
11	Ambetter fee schedule · outpatient · +14 other terms	90	$5,460	$4,385	$66.73 – $8,001
12	Aetna Better Health fee schedule · outpatient · +12 other terms	79	$1,119	$1,308	$231.51 – $11,400
13	Devoted fee schedule · outpatient · +9 other terms	78	$3,383	$2,992	$236.14 – $3,705
14	Healthcare Highways case rate · outpatient · +2 other terms	76	$3,723	$4,173	$2,671 – $5,524
15	Caresource fee schedule · outpatient · +12 other terms	59	$3,061	$2,564	$124.85 – $5,666
16	Highmark facility · fee schedule · outpatient · +12 other terms	56	$3,387	$3,278	$3.36 – $11,473
17	Tricare facility · fee schedule · outpatient · +16 other terms	48	$3,530	$4,190	$110.89 – $11,885
18	Optum fee schedule · outpatient · +18 other terms	43	$3,008	$4,117	$252.53 – $21,852
19	MultiPlan fee schedule · outpatient · +21 other terms	41	$3,903	$4,859	$225.00 – $13,733
20	Superior Healthplan case rate · outpatient · +5 other terms	38	$948.00	$1,023	$929.00 – $4,872
21	Amerihealth Caritas case rate · outpatient · +10 other terms	35	$700.22	$5,009	$661.50 – $10,472
22	Regence professional · fee schedule · outpatient · +13 other terms	35	$202.14	$332.58	$104.39 – $809.16
23	Bcbs Tx fee schedule · outpatient · +2 other terms	34	$3,885	$3,767	$886.62 – $10,870
24	Clover fee schedule · outpatient · +8 other terms	33	$3,544	$3,490	$2,993 – $3,920
25	Cigna Healthspring fee schedule · outpatient · +7 other terms	32	$3,195	$2,266	$930.95 – $3,535

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