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

Posted commercial rates at 28 Washington hospitals, each next to its own Medicare base rate.

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CPT 42820

HospitalMedian across insurers× MedicareInsurersFile date
Astria Toppenish Hospital Toppenish$6,0330.9×32026-04-01
Providence St Mary Medical Center Walla Walla$11,6301.8×62026-04-01
Legacy Salmon Creek Medical Center Vancouver$12,2271.9×72026-04-01
Providence Regional Medical Center Everett Everett$13,4722.0×72026-04-01
St Elizabeth Hospital Enumclaw$14,4732.1×72026-02-28
St Clare Hospital Lakewood$14,5292.1×92026-02-28
St Joseph Medical Center Tacoma$14,5292.1×92026-02-28
St Francis Community Hospital Federal Way$14,5292.1×92026-02-28
St Anthony Hospital Gig Harbor$14,9602.2×92026-02-28
Swedish Issaquah Issaquah$15,2612.2×72026-04-01
Overlake Hospital Medical Center Bellevue$15,3302.2×62026-04-01
St Anne Hospital Burien$15,5342.3×82026-02-28
Multicare Capital Medical Center Olympia$15,9902.4×82026-08-27
Providence Holy Family Hospital Spokane$16,6822.5×62026-04-01
Swedish Edmonds Hospital Edmonds$16,7322.5×62026-04-01
Kadlec Regional Medical Center Richland$16,9432.6×42026-04-01
Multicare Valley Hospital Spokane$17,2142.6×62026-08-27
Multicare Deaconess Hospital Spokane$17,3222.6×52026-08-27
Virginia Mason Medical Center Seattle$18,2912.7×72026-01-01
Multicare Auburn Medical Center Auburn$20,6903.0×82026-08-27
Tacoma General Allenmore Hospital Tacoma$20,6903.0×82026-08-27
Multicare Covington Medical Center Covington$20,6903.0×82026-08-27
Swedish Medical Center / Cherry Hill Seattle$20,7293.0×72026-04-01
Swedish Medical Center Seattle$20,9243.0×72026-04-01
Multicare Good Samaritan Hospital Puyallup$23,3003.4×62026-08-27
St Michael Medical Center Bremerton$25,1663.7×32026-02-28
Providence Centralia Hospital Centralia$27,0044.1×42026-04-01
Mary Bridge Children'S Hospital Tacoma$30,6024.4×52026-08-27

Questions

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

28 Washington 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 28 hospitals is $16,707, 2.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.