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.
Original text from hospital filings
TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>
Vero Beach, FL
See all hospitals reporting CPT 42826 →Price type
Indian River Memorial Hospital Inc’s median price of $1.1k is 68% below the median hospital's median price ($3.5k), higher than 19% of the 1,919 hospitals reporting CPT 42826. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 payers, 41 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 | Optum managed medicaid professional · fee schedule · outpatient | $193.48 | $193.48 | $193.48 – $193.48 |
| 2 | Medicaid managed medicaid professional · fee schedule · outpatient | $199.66 | $199.66 | $199.66 – $199.66 |
| 3 | Molina managed medicaid professional · fee schedule · outpatient | $199.66 | $199.66 | $199.66 – $199.66 |
| 4 | WellCare managed medicaid professional · fee schedule · outpatient | $199.66 | $199.66 | $199.66 – $199.66 |
| 5 | Blue Cross Blue Shield health options professional · fee schedule · outpatient | $239.19 | $239.19 | $239.19 – $239.19 |
| 6 | Blue Cross Blue Shield network blue professional · fee schedule · outpatient | $245.08 | $245.08 | $245.08 – $245.08 |
| 7 | Blue Cross Blue Shield medicare advantage hmo professional · fee schedule · outpatient | $246.99 | $246.99 | $246.99 – $246.99 |
| 8 | Blue Cross Blue Shield medicare advantage ppo professional · fee schedule · outpatient | $246.99 | $246.99 | $246.99 – $246.99 |
| 9 | Magellan medicare advantage professional · fee schedule · outpatient | $246.99 | $246.99 | $246.99 – $246.99 |
| 10 | WellCare medicare advantage professional · fee schedule · outpatient | $246.99 | $246.99 | $246.99 – $246.99 |
| 11 | Blue Cross Blue Shield perferred patient care professional · fee schedule · outpatient | $250.96 | $250.96 | $250.96 – $250.96 |
| 12 | Blue Cross Blue Shield traditional (pps) professional · fee schedule · outpatient | $250.96 | $250.96 | $250.96 – $250.96 |
| 13 | UnitedHealthcare medicare advantage professional · fee schedule · outpatient | $265.15 | $265.15 | $265.15 – $265.15 |
| 14 | Aetna medicare advantage behavioral health professional · fee schedule · outpatient | $296.39 | $296.39 | $296.39 – $296.39 |
| 15 | Aetna medicare advantage pcp professional · fee schedule · outpatient | $306.27 | $306.27 | $306.27 – $306.27 |
| 16 | Aetna medicare advantage specialist professional · fee schedule · outpatient | $311.21 | $311.21 | $311.21 – $311.21 |
| 17 | Aetna ppo first health professional · fee schedule · outpatient | $392.62 | $392.62 | $392.62 – $392.62 |
| 18 | UnitedHealthcare all products professional · fee schedule · outpatient | $513.78 | $513.78 | $513.78 – $513.78 |
| 19 | Aetna pos first health professional · percent of total billed charges · outpatientfrom % of charges | $621.00 | $621.00 | $621.00 – $621.00 |
| 20 | Aetna all products first health professional · percent of total billed charges · outpatientfrom % of charges | $1,242 | $1,242 | $1,242 – $1,242 |
| 21 | Optum managed medicaid facility · case rate · outpatient | $1,292 | $1,292 | $1,292 – $1,292 |
| 22 | Medicaid managed medicaid facility · case rate · outpatient | $1,360 | $1,360 | $1,360 – $1,360 |
| 23 | Molina florida kidcare facility · case rate · outpatient | $1,360 | $1,360 | $1,360 – $1,360 |
| 24 | Molina florida kidcare professional · case rate · outpatient | $1,360 | $1,360 | $1,360 – $1,360 |
| 25 | WellCare managed medicaid facility · case rate · outpatient | $1,360 | $1,360 | $1,360 – $1,360 |
Last updated: Jun 15, 2026
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.