Unlisted throat, adenoid, or tonsil procedure at UPMC East

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 PROC PHARYNX/ADEN/TON

Monroeville, PA

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How this price compares nationally

UPMC East’s median price of $60 is 84% below the median hospital's median price ($375), higher than 2% of the 1,656 hospitals reporting CPT 42999. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 42999 at UPMC East

Negotiated rates from the hospital’s own file: 6 payers, 37 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	Highmark complete blue medicare advantage/freedom blue medicare advantage/security blue medicare advantage facility · fee schedule · outpatient	$19	$19	—	—	—	$19 – $19
2	Highmark managed care - social mission facility · fee schedule · outpatient	$42	$42	—	—	—	$42 – $42
3	UnitedHealthcare compass exchange facility · percent of total billed charges · outpatientfrom % of charges	$42	$42	—	—	—	$42 – $42
4	UnitedHealthcare compass exchange facility · percent of total billed charges · inpatientfrom % of charges	$44	$44	—	—	—	$44 – $44
5	Aetna neighborhood network facility · percent of total billed charges · outpatientfrom % of charges	$45	$45	—	—	—	$45 – $45
6	Aetna neighborhood network facility · percent of total billed charges · inpatientfrom % of charges	$46	$46	—	—	—	$46 – $46
7	Aetna ebr fi facility · percent of total billed charges · inpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
8	Aetna ebr fi facility · percent of total billed charges · outpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
9	Aetna home depot employer group facility · percent of total billed charges · outpatientfrom % of charges	$49	$49	—	—	—	$49 – $49
10	Aetna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges	$50	$50	—	—	—	$50 – $50
11	Cigna nbr aso/fi facility · percent of total billed charges · outpatientfrom % of charges	$50	$50	—	—	—	$50 – $50
12	Cigna new business aso facility · percent of total billed charges · outpatientfrom % of charges	$50	$50	—	—	—	$50 – $50
13	UnitedHealthcare all business facility · percent of total billed charges · outpatientfrom % of charges	$50	$50	—	—	—	$50 – $50
14	Aetna home depot employer group facility · percent of total billed charges · inpatientfrom % of charges	$50	$50	—	—	—	$50 – $50
15	Aetna ebr aso facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
16	Aetna ebr aso facility · percent of total billed charges · outpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
17	Aetna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
18	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
19	Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
20	Cigna ebr facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
21	Cigna ebr facility · percent of total billed charges · outpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
22	Cigna nbr aso/fi facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
23	Cigna new business aso facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
24	UnitedHealthcare all business facility · percent of total billed charges · inpatientfrom % of charges	$51	$51	—	—	—	$51 – $51
25	Highmark commercial - social mission indemnity facility · fee schedule · outpatient	$54	$54	—	—	—	$54 – $54

Page 1 of 2 · 37 rates

Last updated: Mar 6, 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.