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

Posted commercial rates at 6 Ohio hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
University Hospitals - Elyria Medical Center Elyria$3,2560.6×32026-07-14
Cleveland Clinic (main campus) Cleveland$6,2381.1×32026-06-16
Bethesda North Cincinnati$9,8231.7×42026-04-01
Medina Hospital Medina$10,6141.9×12026-06-15
Cleveland Clinic Lutheran Hospital Cleveland$12,1252.2×12026-06-15
Cleveland Clinic Hillcrest Hospital Mayfield Heights$13,7312.5×12026-06-15

Questions

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

6 Ohio 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 6 hospitals is $10,219, 1.8× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.