Tonsil removal surgery for patients aged 12 and over at Champlain Valley Physicians Hospital Medical Center

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

PR TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>

Plattsburgh, NY

See all hospitals reporting CPT 42826 →

SharePost on X LinkedIn

Pricing by billing methodology

Price type

How this price compares nationally

Champlain Valley Physicians Hospital Medical Center’s median price of $391 is 89% below the median hospital's median price ($3.5k), higher than 11% of the 1,919 hospitals reporting CPT 42826. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 42826 at Champlain Valley Physicians Hospital Medical Center

Negotiated rates from the hospital’s own file: 7 payers, 35 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.

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare managed medicaid/essential plans professional · fee schedule · both	$169.56	$169.56	$169.56 – $169.56
2	Blue Cross Blue Shield blue access professional · fee schedule · both	$221.51	$221.51	$221.51 – $221.51
3	Blue Cross Blue Shield hmo professional · fee schedule · both	$234.53	$234.53	$234.53 – $234.53
4	Excellus managed medicaid/essential plans professional · fee schedule · both	$237.56	$237.56	$237.56 – $237.56
5	Aetna medicare advantage professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
6	Blue Cross Blue Shield managed medicaid aliessa professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
7	Blue Cross Blue Shield medicare advantage professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
8	Excellus medicare advantage professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
9	Humana tricare professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
10	UnitedHealthcare medicare advantage professional · fee schedule · both	$242.23	$242.23	$242.23 – $242.23
11	Blue Cross Blue Shield ind professional · fee schedule · both	$247.56	$247.56	$247.56 – $247.56
12	Blue Cross Blue Shield ppo professional · fee schedule · both	$260.59	$260.59	$260.59 – $260.59
13	Highmark ind/fep professional · fee schedule · both	$278.31	$278.31	$278.31 – $278.31
14	Highmark ppo/hmo professional · fee schedule · both	$278.31	$278.31	$278.31 – $278.31
15	Blue Cross Blue Shield essential plans/managed medicaid professional · fee schedule · both	$290.68	$290.68	$290.68 – $290.68
16	Excellus commercial professional · fee schedule · both	$309.05	$309.05	$309.05 – $309.05
17	Aetna commercial professional · fee schedule · both	$370.61	$370.61	$370.61 – $370.61
18	Blue Cross Blue Shield individual network professional · fee schedule · both	$387.57	$387.57	$387.57 – $387.57
19	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$482.88	$482.88	$443.73 – $522.02
20	UnitedHealthcare commercial professional · fee schedule · both	$580.38	$580.38	$580.38 – $580.38
21	MultiPlan group health professional · percent of total billed charges · bothfrom % of charges	$589.00	$589.00	$589.00 – $589.00
22	Excellus managed medicaid/essential plans facility · fee schedule · outpatient	$2,040	$2,040	$2,040 – $2,040
23	Excellus medicare advantage facility · fee schedule · outpatient	$3,746	$3,746	$3,746 – $3,746
24	Humana tricare facility · fee schedule · outpatient	$3,764	$3,764	$3,764 – $3,764
25	Highmark ppo/hmo facility · case rate · outpatient	$3,781	$3,781	$3,781 – $3,781

Page 1 of 2 · 35 rates

Last updated: Apr 28, 2026

Compare to other hospitals

See Tonsil removal surgery for patients aged 12 and over pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.