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

Posted commercial rates at 15 Massachusetts hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Umass Memorial Health-Milford Regional Medical Ctr Milford$5,0570.7×32026-04-01
Umass Memorial Medical Center Inc Worcester$5,2660.7×22026-03-26
South Shore Hospital South Weymouth$5,8970.8×22026-04-01
Emerson Hospital - W Concord$6,5770.9×32026-05-18
Beth Israel Deaconess Hospital-Milton Inc Milton$6,5920.9×12026-04-01
New England Baptist Hospital Boston$6,8101.0×42026-04-01
Beverly Hospital Corporation Beverly$7,3211.0×32026-04-01
Signature Healthcare Brockton Hospital Brockton$8,2391.2×62026-01-28
Winchester Hospital Winchester$9,0391.3×32026-04-01
Anna Jaques Hospital Newburyport$9,1881.3×22026-04-01
Mount Auburn Hospital Cambridge$9,2581.3×22026-04-01
Beth Israel Deaconess Hospital - Plymouth Plymouth$9,6181.4×22026-04-01
Beth Israel Deaconess Hospital - Needham Needham$10,0141.4×32026-04-01
Lahey Hospital & Medical Center, Burlington Burlington$10,7781.5×22026-04-01
Beth Israel Deaconess Medical Center Boston$11,1161.6×32026-04-01

Questions

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

15 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 15 hospitals is $8,239, 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.