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.
Open the interactive explorerAll operations
CPT 42830: Adenoid Removal (Child)
1067 hospitals in 80 markets. National Medicare rate $3,387, surgery center $1,480.
| Market | Hospitals | 25th pct | Median | 75th pct | Low–high |
|---|---|---|---|---|---|
| Alabama (statewide) | 11 | $3,045 | $3,621 | $4,136 | $2,722–$6,376 |
| Alaska (statewide) | 3 | — | — | — | $4,926–$15,079 |
| Arizona (statewide) | 9 | $3,778 | $4,736 | $5,515 | $2,038–$7,469 |
| Arkansas (statewide) | 13 | $2,685 | $3,116 | $3,559 | $1,875–$5,000 |
| Atlanta GA | 6 | $5,890 | $5,890 | $6,107 | $5,890–$6,179 |
| Austin TX | 13 | $2,515 | $5,019 | $5,019 | $2,515–$5,844 |
| Boston MA | 11 | $3,938 | $4,279 | $4,930 | $3,475–$5,606 |
| California (statewide) | 50 | $6,024 | $9,569 | $12,272 | $3,969–$13,497 |
| Charlotte NC | 5 | $3,856 | $3,856 | $3,856 | $3,803–$3,856 |
| Chicago IL | 8 | $5,189 | $6,266 | $7,295 | $3,811–$7,543 |
| Cleveland OH | 11 | $3,450 | $4,474 | $5,182 | $2,694–$6,831 |
| Colorado (statewide) | 15 | $4,884 | $5,473 | $7,028 | $2,214–$10,181 |
| Connecticut (statewide) | 1 | — | — | — | $6,002–$6,002 |
| Dallas-Fort Worth TX | 11 | $5,417 | $5,841 | $6,736 | $5,023–$10,598 |
| Denver CO | 15 | $3,363 | $5,270 | $5,736 | $2,214–$7,526 |
| Detroit MI | 16 | $2,854 | $3,067 | $3,748 | $2,369–$5,812 |
| Florida (statewide) | 54 | $5,646 | $6,965 | $7,517 | $2,273–$12,419 |
| Georgia (statewide) | 29 | $3,806 | $5,400 | $6,179 | $2,439–$17,972 |
| Hawaii (statewide) | 2 | — | — | — | $4,036–$4,229 |
| Houston TX | 19 | $4,608 | $4,807 | $5,172 | $4,254–$6,328 |
| Idaho (statewide) | 15 | $4,018 | $7,370 | $8,237 | $2,845–$12,322 |
| Illinois (statewide) | 27 | $3,823 | $5,288 | $7,295 | $2,843–$9,635 |
| Indiana (statewide) | 29 | $4,394 | $6,076 | $7,016 | $2,274–$12,384 |
| Indianapolis IN | 1 | — | — | — | $13,791–$13,791 |
| Iowa (statewide) | 20 | $3,446 | $4,854 | $7,064 | $3,387–$10,061 |
| Kansas (statewide) | 16 | $4,006 | $4,584 | $5,294 | $2,553–$15,079 |
| Kentucky (statewide) | 17 | $3,893 | $4,491 | $5,390 | $2,709–$8,788 |
| Las Vegas NV | 2 | — | — | — | $3,010–$3,182 |
| Los Angeles CA | 17 | $5,718 | $7,933 | $9,213 | $5,311–$22,055 |
| Louisiana (statewide) | 23 | $2,950 | $3,096 | $3,968 | $2,151–$9,480 |
| Maine (statewide) | 16 | $13,289 | $15,081 | $15,428 | $7,077–$19,397 |
| Maryland (statewide) | 1 | — | — | — | $2,675–$2,675 |
| Massachusetts (statewide) | 4 | — | — | — | $2,532–$4,642 |
| Miami-Fort Lauderdale FL | 1 | — | — | — | $6,055–$6,055 |
| Michigan (statewide) | 26 | $3,086 | $3,632 | $5,284 | $1,854–$7,742 |
| Minneapolis-St. Paul MN | 8 | $4,414 | $4,618 | $4,633 | $2,852–$6,069 |
| Minnesota (statewide) | 12 | $4,694 | $8,602 | $10,058 | $3,466–$11,903 |
| Mississippi (statewide) | 15 | $3,682 | $4,132 | $5,340 | $2,729–$8,032 |
| Missouri (statewide) | 18 | $4,502 | $5,648 | $7,246 | $2,064–$9,202 |
| Montana (statewide) | 5 | $6,448 | $6,810 | $7,500 | $6,181–$9,283 |
| Nashville TN | 8 | $3,442 | $3,680 | $4,342 | $1,869–$6,796 |
| Nebraska (statewide) | 10 | $7,486 | $9,875 | $9,875 | $3,182–$20,585 |
| Nevada (statewide) | 5 | $2,986 | $3,182 | $5,620 | $2,986–$7,744 |
| New Hampshire (statewide) | 6 | $9,065 | $12,224 | $14,384 | $3,548–$14,847 |
| New Jersey (statewide) | 21 | $5,274 | $7,200 | $8,195 | $3,544–$13,320 |
| New Mexico (statewide) | 8 | $5,298 | $6,254 | $9,878 | $3,422–$13,563 |
| New York (statewide) | 30 | $4,250 | $5,204 | $7,254 | $2,531–$10,176 |
| New York City | 7 | $3,542 | $3,542 | $7,805 | $3,542–$11,263 |
| North Carolina (statewide) | 5 | $3,928 | $8,212 | $8,790 | $1,587–$9,044 |
| North Dakota (statewide) | 5 | $5,685 | $5,876 | $7,356 | $5,610–$9,992 |
| Ohio (statewide) | 37 | $3,557 | $6,843 | $9,177 | $1,993–$12,744 |
| Oklahoma (statewide) | 10 | $3,480 | $6,748 | $6,886 | $2,156–$11,390 |
| Oregon (statewide) | 7 | $8,304 | $8,973 | $12,013 | $7,446–$14,848 |
| Pennsylvania (statewide) | 35 | $4,390 | $7,074 | $10,886 | $2,393–$15,251 |
| Philadelphia PA | 10 | $5,794 | $6,405 | $8,494 | $5,527–$13,320 |
| Phoenix AZ | 8 | $3,732 | $3,782 | $3,786 | $3,592–$3,786 |
| Pittsburgh PA | 6 | $5,792 | $6,686 | $7,023 | $4,158–$8,163 |
| Portland OR | 9 | $11,261 | $11,261 | $11,960 | $10,830–$11,960 |
| Research Triangle NC | 1 | — | — | — | $3,175–$3,175 |
| Rhode Island (statewide) | 3 | — | — | — | $6,251–$9,813 |
| Richmond VA | 3 | — | — | — | $6,884–$8,137 |
| Rio Grande Valley TX | 3 | — | — | — | $4,194–$6,736 |
| Salt Lake City UT | 9 | $4,523 | $4,523 | $4,523 | $4,523–$4,523 |
| San Antonio TX | 3 | — | — | — | $4,332–$4,807 |
| San Diego CA | 1 | — | — | — | $7,863–$7,863 |
| San Francisco Bay Area CA | 5 | $7,494 | $8,567 | $10,378 | $7,098–$22,041 |
| Seattle-Tacoma WA | 16 | $9,124 | $9,412 | $11,374 | $8,547–$12,600 |
| South Carolina (statewide) | 19 | $9,488 | $10,678 | $16,082 | $2,685–$20,079 |
| South Dakota (statewide) | 3 | — | — | — | $4,002–$9,052 |
| St. Louis MO | 2 | — | — | — | $2,975–$3,234 |
| Tampa FL | 6 | $6,037 | $6,037 | $6,037 | $4,116–$15,523 |
| Tennessee (statewide) | 20 | $3,173 | $3,410 | $3,788 | $2,567–$6,818 |
| Texas (statewide) | 76 | $3,972 | $5,001 | $5,391 | $2,035–$10,176 |
| Utah (statewide) | 14 | $4,523 | $4,523 | $4,523 | $2,931–$10,840 |
| Vermont (statewide) | 1 | — | — | — | $2,115–$2,115 |
| Virginia (statewide) | 19 | $8,403 | $9,428 | $10,492 | $5,146–$12,578 |
| Washington (statewide) | 11 | $8,978 | $9,560 | $11,728 | $3,317–$16,825 |
| Washington DC | 9 | $5,866 | $5,866 | $5,866 | $5,051–$6,822 |
| West Virginia (statewide) | 10 | $4,822 | $5,561 | $10,811 | $2,708–$22,072 |
| Wisconsin (statewide) | 31 | $6,168 | $12,346 | $12,346 | $4,744–$12,998 |
Lowest and highest 12 hospital medians
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Frye Regional Medical Center | North Carolina (statewide) | $1,587 | 0.5× | 1 | 2026-07-08 |
| Oaklawn Hospital | Michigan (statewide) | $1,854 | 0.6× | 2 | 2026-03-27 |
| Ascension Saint Thomas Rutherford | Nashville TN | $1,869 | 0.6× | 1 | 2026-01-01 |
| Mercy Hospital Northwest Arkansas | Arkansas (statewide) | $1,875 | 0.6× | 6 | 2026-06-08 |
| Akron Children'S Hospital | Ohio (statewide) | $1,993 | 0.6× | 1 | 2025-11-11 |
| Ennis Regional Medical Center | Texas (statewide) | $2,035 | 0.6× | 1 | 2026-04-01 |
| Yuma Regional Medical Center | Arizona (statewide) | $2,038 | 0.6× | 2 | 2025-09-30 |
| Mercy Hospital Joplin | Missouri (statewide) | $2,064 | 0.6× | 18 | 2026-06-09 |
| Washington Regional Medical Center | Arkansas (statewide) | $2,108 | 0.7× | 13 | 2026-04-01 |
| University Of Vermont Medical Center | Vermont (statewide) | $2,115 | 0.6× | 1 | 2026-04-28 |
| Ochsner Lsu Health Monroe | Louisiana (statewide) | $2,151 | 0.7× | 8 | 2026-04-01 |
| St Mary'S Regional Medical Center | Oklahoma (statewide) | $2,156 | 0.7× | 1 | 2026-09-01 |
| Union Medical Center | South Carolina (statewide) | $16,667 | 5.3× | 4 | 2026-04-01 |
| Mary Bridge Children'S Hospital | Washington (statewide) | $16,825 | 4.3× | 5 | 2026-08-27 |
| Northeast Georgia Medical Center, Inc | Georgia (statewide) | $17,972 | 5.7× | 2 | 2026-04-01 |
| Northeast Georgia Medical Center Habersham | Georgia (statewide) | $17,972 | 6.2× | 2 | 2026-04-01 |
| Northeast Georgia Medical Center Barrow | Georgia (statewide) | $17,972 | 5.4× | 2 | 2026-04-01 |
| Northeast Georgia Medical Center Lumpkin | Georgia (statewide) | $17,972 | 5.4× | 2 | 2026-04-01 |
| Mainehealth Lincoln Hospital | Maine (statewide) | $19,397 | 6.0× | 1 | 2025-09-09 |
| Mcleod Medical Center - Dillon | South Carolina (statewide) | $20,079 | 6.5× | 1 | 2026-07-20 |
| Chi Health St Francis | Nebraska (statewide) | $20,585 | 6.0× | 6 | 2026-02-28 |
| 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 |
| Logan Regional Medical Center | West Virginia (statewide) | $22,072 | 6.9× | 1 | 2026-04-01 |
Every hospital is on its state's page (linked in the market table) and in the interactive explorer.
Questions
How much do commercial insurers pay hospitals for adenoid removal (child)?
Across 1067 hospitals in 80 markets (metro areas and statewide) that post a usable dollar rate, the median commercial rate for CPT 42830, hospital outpatient is $5,646, 1.7× the same hospital's local Medicare base rate. The middle half of hospitals runs $4,030 to $8,191. 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: Frye Regional Medical Center ($1,587), Oaklawn Hospital ($1,854), Ascension Saint Thomas Rutherford ($1,869). Highest: Logan Regional Medical Center ($22,072), Cedars-Sinai Medical Center ($22,055), Stanford Health Care ($22,041). Coverage: every hospital whose price file we could read.