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

Posted commercial rates at 5 California hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Keck Hospital Of Usc Los Angeles$8,0141.1×52026-04-01
Los Robles Hospital & Medical Center Thousand Oaks$11,8551.6×52026-09-01
Cedars-Sinai Medical Center Los Angeles$20,6362.7×32025-11-26
John Muir Medical Center - Walnut Creek Campus Walnut Creek$20,6502.5×62026-03-23
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?

5 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 5 hospitals is $20,636, 2.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.