Price AtlasInteractive atlas · All states · techysurgeon.comAdenoid removal (child): what insurers pay
Removal of the adenoids, primary, under age 12. Commercial negotiated rates by hospital and market, next to Medicare for the same code.
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CPT 42830: Removal of Adenoids
94 hospitals in 33 markets. National Medicare rate $3,387, surgery center $1,480.
| Market | Hospitals | 25th pct | Median | 75th pct | Low–high |
|---|---|---|---|---|---|
| Atlanta GA | 1 | — | — | — | $5,890–$5,890 |
| Austin TX | 2 | — | — | — | $2,515–$5,926 |
| Boston MA | 7 | $3,572 | $3,692 | $4,420 | $3,492–$5,348 |
| California (statewide) | 1 | — | — | — | $13,497–$13,497 |
| Chicago IL | 6 | $4,840 | $5,636 | $6,446 | $3,811–$7,543 |
| Cleveland OH | 5 | $5,944 | $6,130 | $6,791 | $3,405–$7,690 |
| Dallas-Fort Worth TX | 4 | — | — | — | $6,679–$9,693 |
| Denver CO | 7 | $3,706 | $4,633 | $4,810 | $2,853–$5,980 |
| Detroit MI | 7 | $2,688 | $3,067 | $3,067 | $2,369–$5,812 |
| Georgia (statewide) | 1 | — | — | — | $5,051–$5,051 |
| Houston TX | 1 | — | — | — | $5,052–$5,052 |
| Kansas (statewide) | 1 | — | — | — | $7,154–$7,154 |
| Las Vegas NV | 2 | — | — | — | $2,986–$4,179 |
| Los Angeles CA | 2 | — | — | — | $8,770–$22,055 |
| Minneapolis-St. Paul MN | 1 | — | — | — | $2,852–$2,852 |
| Nashville TN | 4 | — | — | — | $1,869–$3,839 |
| New York (statewide) | 1 | — | — | — | $5,783–$5,783 |
| New York City | 2 | — | — | — | $7,886–$9,887 |
| Ohio (statewide) | 1 | — | — | — | $7,016–$7,016 |
| Pennsylvania (statewide) | 1 | — | — | — | $10,042–$10,042 |
| Philadelphia PA | 5 | $5,840 | $9,022 | $9,630 | $5,567–$13,320 |
| Phoenix AZ | 3 | — | — | — | $3,778–$3,786 |
| Portland OR | 6 | $11,261 | $11,261 | $11,785 | $11,261–$11,960 |
| Research Triangle NC | 1 | — | — | — | $3,175–$3,175 |
| Richmond VA | 2 | — | — | — | $6,884–$6,884 |
| Salt Lake City UT | 3 | — | — | — | $4,385–$4,523 |
| San Antonio TX | 1 | — | — | — | $5,500–$5,500 |
| San Francisco Bay Area CA | 2 | — | — | — | $22,002–$22,041 |
| Seattle-Tacoma WA | 6 | $9,993 | $10,814 | $12,755 | $9,893–$14,151 |
| St. Louis MO | 1 | — | — | — | $4,953–$4,953 |
| Tampa FL | 2 | — | — | — | $4,116–$6,037 |
| Washington DC | 4 | — | — | — | $4,209–$6,158 |
| Wisconsin (statewide) | 1 | — | — | — | $4,744–$4,744 |
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Ascension Saint Thomas Rutherford | Nashville TN | $1,869 | 0.6× | 1 | 2026-01-01 |
| Trinity Health Oakland Hospital | Detroit MI | $2,369 | 0.7× | 16 | 2026-03-31 |
| Ascension Seton Medical Center Austin | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Mclaren Port Huron | Detroit MI | $2,588 | 0.8× | 1 | 2025-12-31 |
| Henry Ford Health Rochester Hospital | Detroit MI | $2,789 | 0.8× | 1 | 2026-01-01 |
| Ascension Saint Thomas Hospital (Midtown + West) | Nashville TN | $2,848 | 0.9× | 2 | 2026-01-01 |
| Park Nicollet Methodist Hospital | Minneapolis-St. Paul MN | $2,852 | 0.8× | 4 | 2026-03-31 |
| Adventhealth Porter | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Adventhealth Parker | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Henderson Hospital | Las Vegas NV | $2,986 | 0.8× | 4 | 2026-09-01 |
| Corewell Health Beaumont Grosse Pointe Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health William Beaumont University Hospit | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health Beaumont Troy Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| North Carolina Specialty Hospital | Research Triangle NC | $3,175 | 1.0× | 1 | 2026-02-25 |
| University Hospitals - Elyria Medical Center | Cleveland OH | $3,405 | 1.1× | 4 | 2026-07-14 |
| Beth Israel Deaconess Hospital - Plymouth | Boston MA | $3,492 | 0.9× | 2 | 2026-04-01 |
| Lahey Hospital & Medical Center, Burlington | Boston MA | $3,568 | 0.9× | 2 | 2026-04-01 |
| Winchester Hospital | Boston MA | $3,577 | 0.9× | 3 | 2026-04-01 |
| Beverly Hospital Corporation | Boston MA | $3,692 | 0.9× | 4 | 2026-04-01 |
| Vanderbilt University Medical Center | Nashville TN | $3,719 | 1.2× | 7 | 2025-10-01 |
| HonorHealth Scottsdale Thompson Peak Medical Center | Phoenix AZ | $3,778 | 1.1× | 4 | 2026-04-01 |
| HonorHealth Scottsdale Osborn Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| HonorHealth Scottsdale Shea Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| Endeavor Health Northwest Community Hospital | Chicago IL | $3,811 | 1.1× | 3 | 2026-04-01 |
| TriStar StoneCrest Medical Center | Nashville TN | $3,839 | 1.2× | 5 | 2026-09-01 |
| New England Baptist Hospital | Boston MA | $3,906 | 1.0× | 4 | 2026-04-01 |
| Tampa General Hospital | Tampa FL | $4,116 | 1.2× | 3 | 2026-04-01 |
| University Medical Center of Southern Nevada | Las Vegas NV | $4,179 | 1.2× | 7 | 2026-07-01 |
| George Washington Univ Hospital | Washington DC | $4,209 | 1.1× | 3 | 2026-09-01 |
| Mckay-Dee Hospital | Salt Lake City UT | $4,385 | 1.3× | 2 | 2026-08-05 |
| Intermountain Health Utah Valley Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Lds Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| HCA HealthONE Swedish | Denver CO | $4,559 | 1.3× | 4 | 2026-09-01 |
| HCA HealthONE Sky Ridge | Denver CO | $4,633 | 1.3× | 4 | 2026-09-01 |
| Endeavor Health Edward Hospital | Chicago IL | $4,666 | 1.3× | 2 | 2026-04-01 |
| Orthopaedic Hospital Of Wisconsin | Wisconsin (statewide) | $4,744 | 1.4× | 3 | 2026-01-01 |
| Hca Healthone Rose | Denver CO | $4,762 | 1.4× | 4 | 2026-09-01 |
| HCA HealthONE Presbyterian/St. Luke's | Denver CO | $4,857 | 1.4× | 4 | 2026-09-01 |
| Anna Jaques Hospital | Boston MA | $4,933 | 1.2× | 3 | 2026-04-01 |
| Mercy Hospital St Louis | St. Louis MO | $4,953 | 1.5× | 1 | 2026-06-04 |
| Reston Hospital Center | Washington DC | $4,988 | 1.4× | 4 | 2026-09-01 |
| Stonesprings Hospital Center | Washington DC | $4,995 | 1.5× | 4 | 2026-09-01 |
| Emory Houston Hospital Warner Robins | Georgia (statewide) | $5,051 | 1.7× | 3 | 2026-04-01 |
| Houston Methodist Hospital | Houston TX | $5,052 | 1.5× | 6 | 2026-04-01 |
| Beth Israel Deaconess Medical Center | Boston MA | $5,348 | 1.4× | 2 | 2026-04-01 |
| Endeavor Health Elmhurst Hospital | Chicago IL | $5,363 | 1.5× | 2 | 2026-04-01 |
| Methodist Hospital | San Antonio TX | $5,500 | 1.6× | 5 | 2026-09-01 |
| Riddle Memorial Hospital | Philadelphia PA | $5,567 | 1.6× | 2 | 2026-04-01 |
| Stony Brook University Hospital | New York (statewide) | $5,783 | 1.4× | 5 | 2026-06-10 |
| Harper University Hospital | Detroit MI | $5,812 | 1.8× | 1 | 2026-09-02 |
| Bryn Mawr Hospital | Philadelphia PA | $5,840 | 1.7× | 2 | 2026-04-01 |
| Emory University Hospital | Atlanta GA | $5,890 | 1.8× | 6 | 2026-04-01 |
| Endeavor Health Evanston Hospital | Chicago IL | $5,908 | 1.7× | 2 | 2026-04-01 |
| St David's Medical Center | Austin TX | $5,926 | 1.8× | 5 | 2026-09-01 |
| Medina Hospital | Cleveland OH | $5,944 | 1.9× | 1 | 2026-06-15 |
| UCHealth University of Colorado Hospital | Denver CO | $5,980 | 1.7× | 3 | 2025-11-01 |
| Morton Plant Hospital | Tampa FL | $6,037 | 1.7× | 2 | 2026-01-01 |
| Cleveland Clinic (main campus) | Cleveland OH | $6,130 | 1.9× | 4 | 2026-06-16 |
| Inova Alexandria Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Loyola University Medical Center | Chicago IL | $6,625 | 1.9× | 1 | 2026-03-31 |
| Medical City Plano | Dallas-Fort Worth TX | $6,679 | 2.0× | 5 | 2026-09-01 |
| Baylor University Medical Center | Dallas-Fort Worth TX | $6,703 | 2.0× | 3 | 2026-06-29 |
| Cleveland Clinic Lutheran Hospital | Cleveland OH | $6,791 | 2.2× | 1 | 2026-06-15 |
| CJW Medical Center (Chippenham + Johnston-Willis) | Richmond VA | $6,884 | 2.1× | 4 | 2026-09-01 |
| Henrico Doctors' Hospital | Richmond VA | $6,884 | 2.1× | 4 | 2026-09-01 |
| Bethesda North | Ohio (statewide) | $7,016 | 2.2× | 4 | 2026-04-01 |
| Menorah Medical Center | Kansas (statewide) | $7,154 | 2.3× | 5 | 2026-09-01 |
| University of Chicago Medical Center | Chicago IL | $7,543 | 2.1× | 2 | 2026-04-01 |
| Medical City Mckinney | Dallas-Fort Worth TX | $7,544 | 2.3× | 5 | 2026-09-01 |
| Cleveland Clinic Hillcrest Hospital | Cleveland OH | $7,690 | 2.5× | 1 | 2026-06-15 |
| Montefiore Medical Center | New York City | $7,886 | 1.9× | 8 | 2026-04-01 |
| Keck Hospital Of Usc | Los Angeles CA | $8,770 | 2.1× | 5 | 2026-04-01 |
| Jefferson Stratford Hospital | Philadelphia PA | $9,022 | 2.4× | 3 | 2026-09-15 |
| Thomas Jefferson University Hospital | Philadelphia PA | $9,630 | 2.8× | 3 | 2026-09-15 |
| Texas Health Presbyterian Hospital Dallas | Dallas-Fort Worth TX | $9,693 | 2.9× | 2 | 2026-04-21 |
| NYU Langone Hospitals (Orthopedic Hospital + Tisch files) | New York City | $9,887 | 2.4× | 7 | 2026-01-01 |
| Overlake Hospital Medical Center | Seattle-Tacoma WA | $9,893 | 2.6× | 5 | 2026-04-01 |
| St Clare Hospital | Seattle-Tacoma WA | $9,949 | 2.6× | 6 | 2026-02-28 |
| Lehigh Valley Hospital | Pennsylvania (statewide) | $10,042 | 3.0× | 8 | 2026-07-01 |
| St Anthony Hospital | Seattle-Tacoma WA | $10,125 | 2.6× | 6 | 2026-02-28 |
| Legacy Emanuel Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Good Samaritan Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Mount Hood Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Meridian Park Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Swedish Medical Center | Seattle-Tacoma WA | $11,504 | 3.0× | 5 | 2026-04-01 |
| Providence St Vincent Medical Center | Portland OR | $11,960 | 3.3× | 3 | 2026-04-01 |
| Providence Portland Medical Center | Portland OR | $11,960 | 3.3× | 3 | 2026-04-01 |
| Tacoma General Allenmore Hospital | Seattle-Tacoma WA | $13,172 | 3.4× | 5 | 2026-08-27 |
| Inspira Medical Center Mullica Hill | Philadelphia PA | $13,320 | 3.6× | 1 | 2026-03-24 |
| Los Robles Hospital & Medical Center | California (statewide) | $13,497 | 3.2× | 5 | 2026-09-01 |
| Multicare Good Samaritan Hospital | Seattle-Tacoma WA | $14,151 | 3.7× | 4 | 2026-08-27 |
| John Muir Medical Center - Walnut Creek Campus | San Francisco Bay Area CA | $22,002 | 4.7× | 6 | 2026-03-23 |
| Stanford Health Care | San Francisco Bay Area CA | $22,041 | 4.5× | 3 | 2026-04-01 |
| Cedars-Sinai Medical Center | Los Angeles CA | $22,055 | 5.2× | 3 | 2025-11-26 |
Questions
How much do commercial insurers pay hospitals for adenoid removal (child)?
Across 94 hospitals in 33 metro areas that post a usable dollar rate, the median commercial rate for CPT 42830, hospital outpatient is $5,534, 1.6× the same hospital's local Medicare base rate. The middle half of hospitals runs $3,818 to $7,837. Figures are each hospital's median across insurers, from its federal price-transparency file.
What does Medicare pay for adenoid removal (child)?
Medicare's national hospital outpatient rate for CPT 42830 is $3,387 and its surgery-center rate is $1,480, before local wage adjustment.
Which hospitals post the lowest and highest commercial rates for adenoid removal (child)?
Lowest medians: Ascension Saint Thomas Rutherford ($1,869), Trinity Health Oakland Hospital ($2,369), Ascension Seton Medical Center Austin ($2,515). Highest: Cedars-Sinai Medical Center ($22,055), Stanford Health Care ($22,041), John Muir Medical Center - Walnut Creek Campus ($22,002). Coverage is limited to the markets listed on this page.