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

Posted commercial rates at 50 Pennsylvania hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Jefferson Lansdale Hospital Lansdale$4,0960.7×52026-09-15
Upmc Horizon Greenville$4,6750.8×22026-03-06
Holy Redeemer Hospital And Medical Center Meadowbrook$4,9620.9×52026-09-21
Riddle Memorial Hospital Media$5,1560.8×22026-04-01
Upmc Northwest Seneca$5,2500.9×22026-03-06
Paoli Hospital Paoli$5,4080.9×22026-04-01
Upmc Bedford Memorial Everett$5,4350.9×22026-03-06
Jefferson Abington Hospital Abington$5,4380.9×52026-09-15
Bryn Mawr Hospital Bryn Mawr$5,4800.9×22026-04-01
Lankenau Medical Center Wynnewood$5,5491.0×22026-04-01
Upmc Altoona Altoona$5,7291.0×12026-03-06
Wayne Memorial Hospital Honesdale$6,3571.1×12026-09-16
Upmc Memorial York$6,4131.1×52026-03-06
Wellspan York Hospital York$6,4201.1×32026-01-01
Upmc Somerset Somerset$6,4411.1×22026-03-06
Upmc Hamot Erie$6,5191.1×32026-03-06
Jefferson Einstein Montgomery Hospital East Norriton$7,2461.3×62026-09-15
Jefferson Health-Northeast Philadelphia$7,3681.2×62026-09-15
Saint Vincent Hospital Erie$7,9861.4×72026-04-14
St Luke'S Hospital Bethlehem Bethlehem$8,1951.4×32026-02-26
St Luke'S Hospital - Monroe Campus Stroudsburg$8,1951.4×32026-02-27
St Luke'S Hospital - Carbon Campus Lehighton$8,1951.4×32026-02-27
Wellspan Evangelical Community Hospital Lewisburg$8,8111.5×62026-01-01
Upmc Hanover Hanover$9,0421.6×32026-03-06
Thomas Jefferson University Hospital Philadelphia$9,3041.5×42026-09-15
Upmc Washington Washington$10,0821.8×42026-03-06
Jefferson Hospital Jefferson Hills$10,7241.9×62026-04-14
Uniontown Hospital Uniontown$10,9791.9×42026-07-09
St Luke'S Miners Memorial Hospital Coaldale$11,8962.1×22026-02-27
Allegheny Valley Hospital Natrona$12,0132.1×62026-04-14
Canonsburg General Hospital Canonsburg$12,0442.1×62026-04-14
Grove City Hospital Grove City$12,1052.1×52026-04-14
Forbes Hospital Monroeville$12,3772.1×62026-04-14
Lehigh Valley Hospital Allentown$12,5302.1×82026-07-01
Geisinger St. Luke'S Hospital Orwigsburg$12,6172.2×22026-02-26
Ahn Wexford Hospital Wexford$12,9542.3×62026-04-14
St Luke'S Hospital - Upper Bucks Campus Quakertown$13,0782.3×22026-02-26
St Clair Hospital Pittsburgh$13,2312.3×72026-03-31
Allegheny General Hospital Pittsburgh$14,8902.6×62026-04-14
West Penn Hospital Pittsburgh$14,9592.6×62026-04-14
Wellspan Ephrata Community Hospital Ephrata$15,1382.6×22026-01-01
Lehigh Valley Hospital - Dickson City Dickson City$16,8552.9×82026-07-01
Lehigh Valley Hospital - Hazleton Hazleton$18,1063.1×82026-07-01
Lehigh Valley Hospital - Pocono East Stroudsburg$19,5813.4×82026-07-01
Penn State Health Hampden Medical Center Enola$19,7823.3×12026-03-27
Penn State Health Holy Spirit Medical Center Camp Hill$20,0003.4×12026-03-27
Penn State Health Lancaster Medical Center Lancaster$20,3103.5×12026-03-27
Lehigh Valley Hospital - Macungie Macungie$21,1233.5×82026-07-01
Wellspan Chambersburg Hospital Chambersburg$24,0014.0×22026-01-01
Penn State Health St. Joseph Reading$26,1794.3×12026-03-27

Questions

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

50 Pennsylvania 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 50 hospitals is $9,693, 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.