Tonsil and adenoid removal for patients under 12 at Inova Loudoun Hospital

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

Remove tonsils and adenoids

Leesburg, VA

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Pricing by billing methodology

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How this price compares nationally

Inova Loudoun Hospital’s median price of $5.8k is about the same as the median hospital's median price ($5.8k), higher than 51% of the 1,858 hospitals reporting CPT 42820. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 42820 at Inova Loudoun Hospital

Negotiated rates from the hospital’s own file: 7 payers, 25 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	Anthem medicaid advantage fee schedule · both	$3,108	$3,108	$3,108 – $3,108
2	UnitedHealthcare medicaid advantage fee schedule · both	$3,170	$3,170	$3,170 – $3,170
3	Humana medicaid advantage fee schedule · both	$3,232	$3,232	$3,232 – $3,232
4	Aetna medicaid advantage fee schedule · both	$3,263	$3,263	$3,263 – $3,263
5	Kaiser medicaid advantage fee schedule · both	$3,418	$3,418	$3,418 – $3,418
6	Cigna exchange fee schedule · both	$4,391	$4,391	$4,391 – $4,391
7	Aetna fannie-mae fee schedule · both	$5,091	$5,091	$5,091 – $5,091
8	UnitedHealthcare exchange fee schedule · both	$5,470	$5,470	$5,470 – $5,470
9	Cigna hmo other · both	$5,689	$5,689	$5,689 – $5,689
10	Cigna ppo other · both	$5,689	$5,689	$5,689 – $5,689
11	Aetna medicare advantage fee schedule · both	$5,916	$5,916	$5,916 – $5,916
12	Anthem medicare advantage fee schedule · both	$5,916	$5,916	$5,916 – $5,916
13	UnitedHealthcare medicare advantage fee schedule · both	$5,916	$5,916	$5,916 – $5,916
14	Aetna hmo other · both	$5,955	$5,955	$5,955 – $5,955
15	Aetna ppo other · both	$5,955	$5,955	$5,955 – $5,955
16	Cigna medicare advantage fee schedule · both	$6,152	$6,152	$6,152 – $6,152
17	Kaiser medicare advantage fee schedule · both	$6,152	$6,152	$6,152 – $6,152
18	UnitedHealthcare nonoptions other · both	$6,158	$6,158	$6,158 – $6,158
19	UnitedHealthcare options fee schedule · both	$6,158	$6,158	$6,158 – $6,158
20	Humana medicare advantage fee schedule · both	$6,507	$6,507	$6,507 – $6,507
21	Carefirst hmo other · both	$9,927	$9,927	$9,927 – $9,927
22	Carefirst ppo other · both	$10,024	$10,024	$10,024 – $10,024
23	Anthem exchange hmo fee schedule · both	$13,818	$13,818	$13,818 – $13,818
24	Anthem hmo other · both	$15,929	$15,929	$15,929 – $15,929
25	Anthem ppo other · both	$15,929	$15,929	$15,929 – $15,929

Last updated: Apr 1, 2026

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