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

Posted commercial rates at 7 Massachusetts hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Beverly Hospital Corporation Beverly$5,7040.8×22026-04-01
New England Baptist Hospital Boston$6,8911.0×32026-04-01
Winchester Hospital Winchester$8,0661.1×22026-04-01
Beth Israel Deaconess Hospital - Plymouth Plymouth$8,4851.2×12026-04-01
Anna Jaques Hospital Newburyport$9,1881.3×22026-04-01
Lahey Hospital & Medical Center, Burlington Burlington$9,7701.4×12026-04-01
Beth Israel Deaconess Medical Center Boston$10,6041.5×22026-04-01

Questions

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

7 Massachusetts 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 7 hospitals is $8,485, 1.2× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.