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Tonsils and adenoids removal (child under 12) in California: what insurers pay

Posted commercial rates at 77 California hospitals, each next to its own Medicare base rate.

Open in the explorerAll statesEvery bill for the whole procedure

CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Hollywood Presbyterian Medical Center Los Angeles$4,6780.6×22026-03-12
Fresno Surgical Hospital Fresno$4,9760.7×32026-06-16
Providence Cedars Sinai Tarzana Medical Center Tarzana$5,0800.7×52026-04-01
Providence Saint Joseph Medical Ctr Burbank$5,1750.7×52026-04-01
Riverside Community Hospital Riverside$5,8920.8×72026-09-01
Los Angeles Community Hospital Los Angeles$5,9160.8×32026-03-18
Providence Holy Cross Medical Center Mission Hills$6,0350.8×62026-04-01
Community Regional Medical Center Fresno$6,0480.8×82026-06-18
Clovis Community Medical Center Clovis$6,0480.8×82026-06-15
Usc Verdugo Hills Hospital Glendale$6,3080.8×62026-04-01
Foothill Regional Medical Center Tustin$6,5070.8×32026-03-18
Stanford Health Care Tri-Valley Pleasanton$6,6820.8×42026-04-01
Oroville Hospital Oroville$7,6421.0×42026-09-27
Riverside University Health System-Medical Center Moreno Valley$7,7801.0×12026-03-30
Providence Little Co Of Mary Med Ctr San Pedro San Pedro$7,8051.0×52026-04-01
Providence Little Company Of Mary Med Ctr Torrance Torrance$7,8151.0×52026-04-01
Community Hospital Of Huntington Park Huntington Park$8,0491.1×162026-02-04
Memorial Hospital Of Gardena Gardena$8,0491.1×162026-02-04
East Los Angeles Doctors Hospital Los Angeles$8,0491.1×172026-02-04
Coast Plaza Hospital Norwalk$8,0491.1×162026-02-04
Ronald Reagan Ucla Medical Center Los Angeles$8,0841.1×62026-03-29
Ucla West Valley Medical Center West Hills$8,2301.1×32026-03-29
Providence St. Jude Medical Center Fullerton$8,3301.1×62026-04-01
Loma Linda University Children'S Hospital Loma Linda$8,3751.1×92026-09-02
Santa Monica - Ucla Med Ctr & Orthopaedic Hospital Santa Monica$8,4311.1×52026-03-29
Saint John's Health Center Santa Monica$8,6751.1×52026-04-01
Good Samaritan Hospital San Jose$8,7071.0×72026-09-01
San Dimas Community Hospital San Dimas$8,7141.1×82026-09-01
St Mary's Medical Center San Francisco$8,7411.0×72026-04-01
Providence St. Joseph Hospital Orange$9,0821.2×62026-04-01
Providence Mission Hospital Mission Viejo$9,3691.2×62026-04-01
Keck Hospital Of Usc Los Angeles$9,5171.3×92026-04-01
Rady Children'S Hospital - San Diego San Diego$9,6541.3×52026-04-01
Watsonville Community Hospital Watsonville$10,2231.2×142026-09-15
Memorialcare Saddleback Medical Center Laguna Hills$10,4221.4×102026-04-01
Memorialcare Orange Coast Medical Center Fountain Valley$10,5641.4×102026-04-01
Valley Children'S Hospital Madera$10,7441.4×42026-04-01
Providence Queen Of The Valley Medical Center Napa$11,0981.5×52026-04-01
Mission Community Hospital Panorama City$11,3831.5×22026-09-01
Hoag Memorial Hospital Presbyterian Newport Beach$11,4161.5×42026-04-01
John Muir Medical Center - Walnut Creek Campus Walnut Creek$11,6141.4×142026-03-23
Uci Health-Lakewood Lakewood$11,8261.6×62026-04-01
Los Robles Hospital & Medical Center Thousand Oaks$11,8551.6×52026-09-01
Southern California Hospital At Hollywood Hollywood$12,1271.6×32026-03-18
Providence St Joseph Hospital Eureka$12,1501.6×52026-04-01
Providence Santa Rosa Memorial Hospital Santa Rosa$12,8521.6×52026-04-01
Palomar Health Downtown Campus Escondido$13,1111.7×22026-04-01
Palomar Medical Center Poway Poway$14,0401.8×12026-04-01
Memorialcare Long Beach Medical Center Long Beach$15,2082.0×72026-04-01
Kaiser Foundation Hospital - Los Angeles Los Angeles$17,4552.3×12026-04-01
Kaiser Foundation Hospital - Downey Downey$17,4552.3×12026-04-01
Kaiser Foundation Hospital - South Bay Harbor City$17,4552.3×12026-04-01
Kaiser Foundation Hospital - Zion San Diego$17,4552.3×12026-04-01
Kaiser Foundation Hospital - Woodland Hills Woodland Hills$17,4552.3×12026-04-01
Kaiser Foundation Hospital, Riverside Riverside$17,4552.3×12026-04-01
Kaiser Foundation Hospital - Baldwin Park Baldwin Park$17,4552.3×12026-04-01
Kaiser Foundation Hospital-Moreno Valley Moreno Valley$17,4552.3×12026-04-01
Kaiser Foundation Hospital - San Marcos San Marcos$17,4552.3×12026-04-01
Providence St Mary Medical Center Apple Valley$17,9032.4×42026-04-01
University Of California Davis Medical Center Sacramento$18,4642.4×22026-04-01
Providence Redwood Memorial Hospital Fortuna$19,7362.6×42026-04-01
Cedars-Sinai Medical Center Los Angeles$20,6362.7×32025-11-26
Kaiser Foundation Hospital - South San Francisco South San Francisco$22,3862.6×12026-04-01
Kaiser Foundation Hospital-Santa Clara Santa Clara$22,3862.6×12026-04-01
Kaiser Foundation Hospital - Walnut Creek Walnut Creek$22,3862.7×12026-04-01
Kaiser Foundation Hospital - San Francisco San Francisco$22,3862.6×12026-04-01
Regional Medical Center Of San Jose San Jose$22,3862.6×12026-04-01
Kaiser Foundation Hospital - Sacramento Sacramento$22,3862.9×12026-04-01
Kaiser Foundation Hospital - Fremont Fremont$22,3862.7×12026-04-01
Kaiser Foundation Hospital - Redwood City Redwood City$22,3862.6×12026-04-01
Kaiser Foundation Hospital-Santa Rosa Santa Rosa$22,3862.8×12026-04-01
Kaiser Foundation Hospital - Fresno Fresno$22,3862.9×12026-04-01
Kaiser Foundation Hospital - Antioch Antioch$22,3862.7×12026-04-01
Kaiser Foundation Hospital - Vacaville Vacaville$22,3862.7×12026-04-01
Kaiser Foundation Hospital - Roseville Roseville$22,3862.9×12026-04-01
Kaiser Foundation Hospital - San Leandro San Leandro$22,3862.7×12026-04-01
Stanford Health Care Stanford$24,3072.8×42026-04-01

Questions

How much do insurers pay for tonsils and adenoids removal (child under 12) in California?

77 California hospitals post usable commercial rates for tonsils and adenoids removal (child under 12) in their federal price-transparency files. For CPT 42820, hospital outpatient, the median across 77 hospitals is $11,383, 1.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.