Unlisted throat, adenoid, or tonsil procedure at Ascension Seton

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

UNLISTED PX PHRNX ADND/TNSL

Austin, TX

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Pricing by billing methodology

Price type

How this price compares nationally

Ascension Seton’s median price of $225 is 40% below the median hospital's median price ($377), higher than 10% of the 1,647 hospitals reporting CPT 42999. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 42999 at Ascension Seton

Negotiated rates from the hospital’s own file: 9 payers, 21 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Tricare 1229_tricare cah outpatient 20170101 fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
2	Blue Cross Blue Shield 4127_blue cross blue shield bav exchange 20250101 fee schedule · outpatient	$147	$147	—	—	—	$147 – $147
3	Blue Cross Blue Shield 4440_blue cross blue shield hpn 20250501 fee schedule · outpatient	$195	$195	—	—	—	$195 – $195
4	Blue Cross Blue Shield 4497_blue cross blue shield hpn (dell, williamson,hays) 20250501 fee schedule · outpatient	$195	$195	—	—	—	$195 – $195
5	Blue Cross Blue Shield 4095_blue cross blue shield hmo essentials 20250101 fee schedule · outpatient	$210	$210	—	—	—	$210 – $210
6	Aetna 4659_medicare advantage aetna inpatient 20251001 other · inpatient	$225	$225	—	—	—	$225 – $225
7	Aetna 4749_medicare advantage aetna outpatient 20250811 other · outpatient	$225	$225	—	—	—	$225 – $225
8	Devoted 4684_medicare advantage devoted health inpatient 20251001 other · inpatient	$225	$225	—	—	—	$225 – $225
9	Devoted 4918_medicare advantage devoted health outpatient 20250811 other · outpatient	$225	$225	—	—	—	$225 – $225
10	Humana 4661_medicare advantage humana inpatient (aus,hay,nw,sw) 20251001 other · inpatient	$225	$225	—	—	—	$225 – $225
11	Humana 4921_medicare advantage humana outpatient (aus,hay,nw,sw.smv) 20250811 other · outpatient	$225	$225	—	—	—	$225 – $225
12	Tricare 4696_tricare inpatient 20251001 other · inpatient	$225	$225	—	—	—	$225 – $225
13	WellCare 4691_medicare advantage wellcare inpatient 20251001 other · inpatient	$225	$225	—	—	—	$225 – $225
14	WellCare 4929_medicare advantage wellcare outpatient 20250811 other · outpatient	$225	$225	—	—	—	$225 – $225
15	UnitedHealthcare 4687_medicare advantage united healthcare inpatient (aus,nw,sw,hay) 20251001 other · inpatient	$230	$230	—	—	—	$230 – $230
16	UnitedHealthcare 4928_medicare advantage united healthcare outpatient (aus,nw,sw,hay,smv) 20250811 other · outpatient	$230	$230	—	—	—	$230 – $230
17	Blue Cross Blue Shield 4094_blue cross blue shield ppo 20250101 fee schedule · outpatient	$238	$238	—	—	—	$238 – $238
18	Ambetter 4652_superior ambetter inpatient 20251001 other · inpatient	$405	$405	—	—	—	$405 – $405
19	Ambetter 4960_superior ambetter outpatient 20250811 other · outpatient	$405	$405	—	—	—	$405 – $405
20	Humana 206_humana hmo custom 20140201 other · outpatient	$969	$969	—	—	—	$969 – $969
21	Oscar 4511_oscar health plan 20251001 other · both	$1k	$1k	—	—	—	$1k – $1k

Last updated: Jan 1, 2026

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See Unlisted throat, adenoid, or tonsil procedure pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.