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Adenoid removal (child) in Pennsylvania: what insurers pay

Posted commercial rates at 49 Pennsylvania hospitals, each next to its own Medicare base rate.

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CPT 42830

HospitalMedian across insurers× MedicareInsurersFile date
Upmc Horizon Greenville$2,3930.7×22026-03-06
Upmc Northwest Seneca$2,7040.8×22026-03-06
Upmc Bedford Memorial Everett$2,9800.9×22026-03-06
Wayne Memorial Hospital Honesdale$3,5601.1×12026-09-16
Upmc Altoona Altoona$3,7221.1×12026-03-06
Jefferson Hospital Jefferson Hills$4,1581.3×72026-04-14
Upmc Somerset Somerset$4,1741.3×22026-03-06
Holy Redeemer Hospital And Medical Center Meadowbrook$4,1781.3×52026-09-21
Upmc Hamot Erie$4,3061.3×42026-03-06
Saint Vincent Hospital Erie$4,3781.4×72026-04-14
St Luke'S Hospital - Upper Bucks Campus Quakertown$4,4021.4×32026-02-26
Jefferson Lansdale Hospital Lansdale$5,5271.7×52026-09-15
Upmc Washington Washington$5,5271.7×42026-03-06
Jefferson Abington Hospital Abington$5,5271.7×52026-09-15
Riddle Memorial Hospital Media$5,5671.6×22026-04-01
Paoli Hospital Paoli$5,7791.8×22026-04-01
Bryn Mawr Hospital Bryn Mawr$5,8401.7×22026-04-01
Lankenau Medical Center Wynnewood$5,8981.8×22026-04-01
Uniontown Hospital Uniontown$6,1501.9×42026-07-09
St Luke'S Miners Memorial Hospital Coaldale$6,2541.9×32026-02-27
Wellspan York Hospital York$6,4202.0×32026-01-01
Allegheny Valley Hospital Natrona$6,5862.0×62026-04-14
Canonsburg General Hospital Canonsburg$6,6022.0×62026-04-14
Grove City Hospital Grove City$6,6362.1×52026-04-14
Forbes Hospital Monroeville$6,7862.1×62026-04-14
Jefferson Health-Northeast Philadelphia$6,9122.0×62026-09-15
Jefferson Einstein Montgomery Hospital East Norriton$6,9122.1×62026-09-15
Upmc Hanover Hanover$6,9712.1×32026-03-06
Upmc Memorial York$7,0742.2×52026-03-06
Ahn Wexford Hospital Wexford$7,1022.2×62026-04-14
St Clair Hospital Pittsburgh$7,4102.3×72026-03-31
St Luke'S Hospital - Monroe Campus Stroudsburg$8,0502.5×32026-02-27
Allegheny General Hospital Pittsburgh$8,1632.5×62026-04-14
St Luke'S Hospital Bethlehem Bethlehem$8,1952.4×32026-02-26
St Luke'S Hospital - Carbon Campus Lehighton$8,1952.4×32026-02-27
West Penn Hospital Pittsburgh$8,2012.5×62026-04-14
Geisinger St. Luke'S Hospital Orwigsburg$8,7682.7×22026-02-26
Lehigh Valley Hospital Allentown$10,0423.0×82026-07-01
Thomas Jefferson University Hospital Philadelphia$10,3653.0×42026-09-15
Wellspan Ephrata Community Hospital Ephrata$10,6923.3×22026-01-01
Penn State Health Hampden Medical Center Enola$11,0793.3×12026-03-27
Penn State Health Holy Spirit Medical Center Camp Hill$11,2013.4×12026-03-27
Penn State Health Lancaster Medical Center Lancaster$11,3753.5×12026-03-27
Lehigh Valley Hospital - Dickson City Dickson City$11,7223.6×82026-07-01
Wellspan Chambersburg Hospital Chambersburg$13,1584.0×22026-01-01
Lehigh Valley Hospital - Pocono East Stroudsburg$13,2994.1×82026-07-01
Lehigh Valley Hospital - Hazleton Hazleton$13,3904.2×82026-07-01
Penn State Health St. Joseph Reading$14,6624.3×12026-03-27
Lehigh Valley Hospital - Macungie Macungie$15,2514.5×82026-07-01

Questions

How much do insurers pay for adenoid removal (child) in Pennsylvania?

49 Pennsylvania hospitals post usable commercial rates for adenoid removal (child) in their federal price-transparency files. For CPT 42830, hospital outpatient, the median across 49 hospitals is $6,786, 2.1× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.