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

Posted commercial rates at 3 Rhode Island hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Rhode Island Hospital Providence$9,8131.5×52026-04-01
Newport Hospital Newport$10,3901.6×42026-04-01
The Miriam Hospital Providence$11,3701.7×32026-04-01

Questions

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

3 Rhode Island 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 3 hospitals is $10,390, 1.6× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.