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

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

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Corewell Health Beaumont Grosse Pointe Hospital Grosse Pointe$3,0670.5×12026-05-01
Corewell Health William Beaumont University Hospit Royal Oak$3,0670.5×12026-05-01
Corewell Health Beaumont Troy Hospital Troy$3,0670.5×12026-05-01
Henry Ford Health Rochester Hospital Rochester$4,7220.8×12026-01-01
Harper University Hospital Detroit$6,8421.2×22026-09-02

Questions

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

5 Michigan 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 $3,067, 0.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.