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

Posted commercial rates at 46 Ohio hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
East Liverpool City Hospital East Liverpool$3,1560.6×32026-09-01
University Hospitals - Elyria Medical Center Elyria$3,7320.7×42026-07-14
University Hospitals Portage Medical Center Ravenna$3,9420.7×32026-07-14
University Hospitals Ahuja Medical Center Beachwood$3,9420.7×52026-07-14
University Hospitals Conneaut Medical Center Conneaut$4,1220.7×32026-07-14
Parma Community General Hospital Parma$4,2080.8×32026-07-14
University Hospitals St. John Medical Center Westlake$4,2080.8×32026-07-14
Nationwide Children'S Hospital Toledo, Llc Toledo$5,0420.9×32026-04-01
Pomerene Hospital Millersburg$5,4891.0×32026-03-24
Fisher-Titus Hospital Norwalk$5,7151.0×32026-04-29
Union Hospital Dover$5,8811.1×22026-06-15
Euclid Hospital Euclid$6,1611.1×32026-06-15
Cleveland Clinic Lutheran Hospital Cleveland$6,1611.1×32026-06-15
Marymount Hospital Garfield Heights$6,1611.1×32026-06-15
South Pointe Hospital Warrensville Heights$6,1611.1×32026-06-15
Cleveland Clinic (main campus) Cleveland$6,2001.1×62026-06-16
Cleveland Clinic Fairview Hospital Cleveland$6,8311.2×52026-06-15
West Chester Hospital, Llc West Chester$7,6951.3×42026-07-01
Adena Pike Medical Center Waverly$7,7301.4×22026-08-19
University Of Cincinnati Medical Center, Llc Cincinnati$7,9231.4×52026-07-01
Medina Hospital Medina$7,9901.4×42026-06-15
Mercy Medical Center Canton$8,8621.6×12026-06-15
Aultman Hospital Canton$9,2481.6×42026-04-01
Bethesda North Cincinnati$9,8231.7×42026-04-01
Cleveland Clinic Hillcrest Hospital Mayfield Heights$9,9461.8×42026-06-15
Akron General Medical Center Akron$10,1321.8×42026-06-15
Miami Valley Hospital Dayton$10,9411.9×22026-04-01
Atrium Medical Center Franklin$10,9601.9×22026-04-01
Upper Valley Medical Center Troy$11,0981.9×22026-04-01
MetroHealth System Cleveland$11,7612.1×52026-04-01
Adena Fayette Medical Center Washington Ch$12,0962.2×12026-08-19
Kettering Health Greene Memorial Xenia$12,5912.2×62026-04-01
Kettering Health Main Campus Kettering$12,5912.2×62026-04-01
Kettering Health Dayton Dayton$12,5912.2×62026-04-01
Kettering Health Miamisburg Miamisburg$12,5912.2×62026-04-01
Soin Medical Center Beaver Creek$12,5912.2×62026-04-01
Kettering Health Troy Troy$12,5912.2×62026-04-01
Summa Health System Akron$13,1052.3×72026-04-01
Adena Regional Medical Center Chillicothe$13,4242.4×42026-08-19
Mccullough-Hyde Memorial Hospital Oxford$13,8362.4×72026-04-01
Good Samaritan Hospital Cincinnati$13,8362.4×72026-04-01
Marietta Memorial Hospital Marietta$14,0022.5×12026-10-01
Lima Memorial Health System Lima$16,3862.9×22026-04-01
Alliance Community Hospital Alliance$20,2193.6×12026-04-01
Aultman Orrville Hospital Orrville$20,2193.6×12026-04-01
Salem Regional Medical Center Salem$22,7544.1×22026-04-01

Questions

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

46 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 46 hospitals is $9,536, 1.7× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.