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
PR Tonsillectomy Primary or Secondary Age 12 or Older
Darby, PA
See all hospitals reporting CPT 42826 →Price type
Mercy Fitzgerald Hospital’s median price of $118 is 97% below the median hospital's median price ($3.5k), higher than 1% 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: 32 payers, 156 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 | Amerihealth Caritas medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 2 | Amerihealth Caritas medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 3 | Anthem medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 4 | Anthem medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 5 | Blue Cross Blue Shield medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 6 | Blue Cross Blue Shield medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 7 | Carefirst medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 8 | Carefirst medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 9 | Caresource medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 10 | Caresource medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 11 | Cigna medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 12 | Cigna medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 13 | Excellus medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 14 | Excellus medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 15 | First Health medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 16 | First Health medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 17 | Highmark medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 18 | Highmark medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 19 | Humana medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 20 | Humana medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 21 | Kaiser medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 22 | Kaiser medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 23 | Magellan medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 24 | Magellan medicaid professional · fee schedule · outpatient | $99.50 | $99.50 | $99.50 – $99.50 |
| 25 | Medicaid medicaid professional · fee schedule · inpatient | $99.50 | $99.50 | $99.50 – $99.50 |
Last updated: Mar 31, 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.