Price AtlasInteractive atlas · All states · techysurgeon.comTonsillectomy (age 12+): what insurers pay
Tonsil removal, age 12 or over. Commercial negotiated rates by hospital and market, next to Medicare for the same code.
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CPT 42826: Removal of Tonsils
257 hospitals in 38 markets. National Medicare rate $3,387, surgery center $1,480.
| Market | Hospitals | 25th pct | Median | 75th pct | Low–high |
|---|---|---|---|---|---|
| Atlanta GA | 6 | $5,024 | $5,024 | $5,890 | $5,024–$6,179 |
| Austin TX | 13 | $2,515 | $5,844 | $5,926 | $2,515–$5,926 |
| Boston MA | 11 | $3,530 | $3,692 | $4,328 | $2,408–$5,348 |
| California (statewide) | 1 | — | — | — | $13,497–$13,497 |
| Chicago IL | 8 | $4,562 | $5,636 | $7,295 | $3,811–$7,543 |
| Cleveland OH | 10 | $3,908 | $6,091 | $6,791 | $3,174–$7,260 |
| Columbus OH | 1 | — | — | — | $11,925–$11,925 |
| Dallas-Fort Worth TX | 13 | $6,703 | $7,124 | $8,094 | $5,409–$10,598 |
| Denver CO | 15 | $3,682 | $4,762 | $5,733 | $2,853–$8,381 |
| Detroit MI | 14 | $3,067 | $3,166 | $4,566 | $2,866–$5,812 |
| Georgia (statewide) | 1 | — | — | — | $5,051–$5,051 |
| Houston TX | 16 | $4,201 | $4,560 | $5,134 | $3,812–$5,422 |
| Kansas (statewide) | 1 | — | — | — | $7,622–$7,622 |
| Las Vegas NV | 2 | — | — | — | $2,986–$4,179 |
| Los Angeles CA | 16 | $5,624 | $7,931 | $9,383 | $5,196–$25,517 |
| Miami-Fort Lauderdale FL | 1 | — | — | — | $5,038–$5,038 |
| Minneapolis-St. Paul MN | 8 | $4,550 | $4,789 | $4,800 | $2,740–$4,966 |
| Nashville TN | 8 | $3,552 | $3,800 | $3,930 | $2,307–$4,082 |
| New York (statewide) | 1 | — | — | — | $5,783–$5,783 |
| New York City | 8 | $3,245 | $3,620 | $6,592 | $3,245–$9,887 |
| Ohio (statewide) | 1 | — | — | — | $7,016–$7,016 |
| Pennsylvania (statewide) | 1 | — | — | — | $12,530–$12,530 |
| Philadelphia PA | 11 | $6,060 | $6,234 | $7,675 | $5,164–$13,320 |
| Phoenix AZ | 8 | $3,732 | $3,782 | $3,786 | $3,592–$3,786 |
| Pittsburgh PA | 8 | $5,114 | $7,738 | $9,040 | $2,716–$10,352 |
| Portland OR | 8 | $11,261 | $11,261 | $11,960 | $11,261–$11,960 |
| Research Triangle NC | 1 | — | — | — | $3,175–$3,175 |
| Richmond VA | 3 | — | — | — | $6,884–$6,884 |
| Rio Grande Valley TX | 4 | — | — | — | $3,746–$6,736 |
| Salt Lake City UT | 9 | $4,523 | $4,523 | $4,523 | $4,385–$4,523 |
| San Antonio TX | 3 | — | — | — | $3,788–$5,500 |
| San Diego CA | 6 | $4,264 | $4,264 | $5,155 | $4,264–$13,704 |
| San Francisco Bay Area CA | 6 | $9,258 | $16,428 | $22,064 | $7,494–$22,072 |
| Seattle-Tacoma WA | 14 | $9,907 | $10,037 | $12,755 | $7,277–$14,151 |
| St. Louis MO | 4 | — | — | — | $4,953–$4,953 |
| Tampa FL | 6 | $6,037 | $6,037 | $6,037 | $4,116–$15,523 |
| Washington DC | 9 | $4,995 | $6,158 | $6,158 | $4,209–$6,158 |
| Wisconsin (statewide) | 1 | — | — | — | $4,744–$4,744 |
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Ascension Saint Thomas Rutherford | Nashville TN | $2,307 | 0.7× | 1 | 2026-01-01 |
| South Shore Hospital | Boston MA | $2,408 | 0.6× | 2 | 2026-04-01 |
| Ascension Seton Medical Center Austin | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Dell Seton Med Center At The University Of Tx | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Ascension Seton Southwest | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Ascension Seton Northwest | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Cedar Park Regional Medical Center | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Ascension Seton Hays | Austin TX | $2,515 | 0.8× | 1 | 2026-01-01 |
| Upmc Mercy | Pittsburgh PA | $2,716 | 0.8× | 1 | 2026-03-06 |
| Park Nicollet Methodist Hospital | Minneapolis-St. Paul MN | $2,740 | 0.8× | 3 | 2026-03-31 |
| Adventhealth Porter | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Adventhealth Parker | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Adventhealth Littleton | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Adventhealth Castle Rock | Denver CO | $2,853 | 0.8× | 4 | 2026-04-01 |
| Trinity Health Oakland Hospital | Detroit MI | $2,866 | 0.9× | 16 | 2026-03-31 |
| Henderson Hospital | Las Vegas NV | $2,986 | 0.8× | 4 | 2026-09-01 |
| Ascension Saint Thomas Hospital (Midtown + West) | Nashville TN | $3,052 | 1.0× | 2 | 2026-01-01 |
| Corewell Health Beaumont Grosse Pointe Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health William Beaumont University Hospit | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health Beaumont Troy Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health Wayne Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health Farmington Hills Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| Corewell Health Trenton Hospital | Detroit MI | $3,067 | 0.9× | 1 | 2026-05-01 |
| University Hospitals - Elyria Medical Center | Cleveland OH | $3,174 | 1.0× | 4 | 2026-07-14 |
| North Carolina Specialty Hospital | Research Triangle NC | $3,175 | 1.0× | 1 | 2026-02-25 |
| LINCOLN MEDICAL & MENTAL HEALTH CENTER | New York City | $3,245 | 0.8× | 5 | 2026-09-05 |
| Jacobi Medical Center | New York City | $3,245 | 0.8× | 5 | 2026-09-05 |
| Elmhurst Hospital Center | New York City | $3,245 | 0.8× | 5 | 2026-09-05 |
| South Brooklyn Health | New York City | $3,245 | 0.8× | 5 | 2026-09-05 |
| Trinity Health Livonia Hospital | Detroit MI | $3,265 | 1.0× | 15 | 2026-03-31 |
| Emerson Hospital - | Boston MA | $3,284 | 0.8× | 2 | 2026-05-18 |
| Henry Ford Health Rochester Hospital | Detroit MI | $3,374 | 1.0× | 1 | 2026-01-01 |
| University Hospitals St. John Medical Center | Cleveland OH | $3,402 | 1.1× | 4 | 2026-07-14 |
| Beth Israel Deaconess Hospital - Plymouth | Boston MA | $3,492 | 0.9× | 2 | 2026-04-01 |
| Upmc East | Pittsburgh PA | $3,523 | 1.1× | 1 | 2026-03-06 |
| Lahey Hospital & Medical Center, Burlington | Boston MA | $3,568 | 0.9× | 2 | 2026-04-01 |
| Winchester Hospital | Boston MA | $3,577 | 0.9× | 3 | 2026-04-01 |
| Chandler Regional Medical Center (Dignity) | Phoenix AZ | $3,592 | 1.0× | 2 | 2026-02-28 |
| Mercy Gilbert Medical Center (Dignity) | Phoenix AZ | $3,592 | 1.0× | 2 | 2026-02-28 |
| MetroHealth System | Cleveland OH | $3,619 | 1.1× | 4 | 2026-04-01 |
| Beverly Hospital Corporation | Boston MA | $3,692 | 0.9× | 4 | 2026-04-01 |
| Vanderbilt University Medical Center | Nashville TN | $3,719 | 1.2× | 7 | 2025-10-01 |
| Vanderbilt Wilson County Hospital | Nashville TN | $3,719 | 1.2× | 7 | 2025-10-01 |
| Harlingen Medical Center | Rio Grande Valley TX | $3,746 | 1.1× | 3 | 2026-09-01 |
| HonorHealth Scottsdale Thompson Peak Medical Center | Phoenix AZ | $3,778 | 1.1× | 4 | 2026-04-01 |
| HonorHealth Sonoran Crossing Medical Center | Phoenix AZ | $3,778 | 1.1× | 4 | 2026-04-01 |
| HonorHealth Scottsdale Osborn Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| HonorHealth Scottsdale Shea Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| HonorHealth John C. Lincoln Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| HonorHealth Deer Valley Medical Center | Phoenix AZ | $3,786 | 1.1× | 5 | 2026-04-01 |
| University Health System | San Antonio TX | $3,788 | 1.1× | 4 | 2025-10-14 |
| Endeavor Health Northwest Community Hospital | Chicago IL | $3,811 | 1.1× | 3 | 2026-04-01 |
| Baylor St. Luke's Medical Center | Houston TX | $3,812 | 1.1× | 7 | 2026-02-28 |
| TriStar Skyline Medical Center | Nashville TN | $3,880 | 1.2× | 5 | 2026-09-01 |
| TriStar Summit Medical Center | Nashville TN | $3,880 | 1.2× | 5 | 2026-09-01 |
| New England Baptist Hospital | Boston MA | $3,906 | 1.0× | 4 | 2026-04-01 |
| Jamaica Hospital Medical Center | New York City | $3,996 | 1.0× | 5 | 2026-03-25 |
| Regions Hospital | Minneapolis-St. Paul MN | $4,072 | 1.2× | 1 | 2026-03-31 |
| TriStar StoneCrest Medical Center | Nashville TN | $4,082 | 1.3× | 5 | 2026-09-01 |
| TriStar Hendersonville Medical Center | Nashville TN | $4,082 | 1.3× | 5 | 2026-09-01 |
| Tampa General Hospital | Tampa FL | $4,116 | 1.2× | 3 | 2026-04-01 |
| University Medical Center of Southern Nevada | Las Vegas NV | $4,179 | 1.2× | 7 | 2026-07-01 |
| Houston Methodist Baytown Hospital | Houston TX | $4,201 | 1.3× | 6 | 2026-04-01 |
| Houston Methodist Sugar Land Hospital | Houston TX | $4,201 | 1.3× | 6 | 2026-04-01 |
| Houston Methodist West Hospital | Houston TX | $4,201 | 1.3× | 6 | 2026-04-01 |
| Houston Methodist The Woodlands Hospital | Houston TX | $4,201 | 1.3× | 6 | 2026-04-01 |
| George Washington Univ Hospital | Washington DC | $4,209 | 1.1× | 3 | 2026-09-01 |
| Northwestern Memorial Hospital | Chicago IL | $4,250 | 1.2× | 1 | 2026-04-01 |
| St. Luke's Health Sugar Land Hospital | Houston TX | $4,255 | 1.3× | 7 | 2026-02-28 |
| Scripps Green Hospital | San Diego CA | $4,264 | 1.0× | 1 | 2026-03-30 |
| Scripps Mercy Hospital | San Diego CA | $4,264 | 1.0× | 1 | 2026-03-30 |
| Scripps Memorial Hospital La Jolla | San Diego CA | $4,264 | 1.0× | 1 | 2026-03-30 |
| Scripps Memorial Hospital - Encinitas | San Diego CA | $4,264 | 1.0× | 1 | 2026-03-30 |
| Beth Israel Deaconess Hospital - Needham | Boston MA | $4,297 | 1.1× | 2 | 2026-04-01 |
| Chi St Luke's Health Brazosport | Houston TX | $4,328 | 1.3× | 4 | 2026-02-28 |
| Mount Auburn Hospital | Boston MA | $4,358 | 1.1× | 1 | 2026-04-01 |
| St. Luke's Health The Woodlands Hospital | Houston TX | $4,380 | 1.3× | 7 | 2026-02-28 |
| Mckay-Dee Hospital | Salt Lake City UT | $4,385 | 1.3× | 2 | 2026-08-05 |
| Trinity Health Livingston Hospital | Detroit MI | $4,507 | 1.4× | 15 | 2026-03-31 |
| Uchealth Highlands Ranch Hospital | Denver CO | $4,512 | 1.3× | 4 | 2025-11-01 |
| Intermountain Health Utah Valley Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Lds Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Intermountain Medical Center | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| American Fork Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Orem Community Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Intermountain Health Alta View Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Intermountain Health Layton Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| Intermountain Health Spanish Fork Hospital | Salt Lake City UT | $4,523 | 1.4× | 2 | 2026-08-05 |
| HCA HealthONE Swedish | Denver CO | $4,559 | 1.3× | 4 | 2026-09-01 |
| Henry Ford Health Macomb Hospital | Detroit MI | $4,586 | 1.4× | 2 | 2026-06-28 |
| HCA HealthONE Sky Ridge | Denver CO | $4,633 | 1.3× | 4 | 2026-09-01 |
| Endeavor Health Edward Hospital | Chicago IL | $4,666 | 1.3× | 2 | 2026-04-01 |
| M Health Fairview Southdale Hospital | Minneapolis-St. Paul MN | $4,709 | 1.4× | 4 | 2026-02-06 |
| Hca Houston Healthcare Clear Lake | Houston TX | $4,741 | 1.4× | 5 | 2026-09-01 |
| Orthopaedic Hospital Of Wisconsin | Wisconsin (statewide) | $4,744 | 1.4× | 3 | 2026-01-01 |
| Doctors Hospital at Renaissance | Rio Grande Valley TX | $4,759 | 1.4× | 2 | 2026-04-01 |
| Hca Healthone Rose | Denver CO | $4,762 | 1.4× | 4 | 2026-09-01 |
| University Hospitals Ahuja Medical Center | Cleveland OH | $4,774 | 1.5× | 1 | 2026-07-14 |
| M Health Fairview University of Minnesota Medical Center | Minneapolis-St. Paul MN | $4,778 | 1.4× | 4 | 2026-02-06 |
| M Health Fairview Lakes Medical Center | Minneapolis-St. Paul MN | $4,800 | 1.4× | 4 | 2026-02-05 |
| M Health Fairview Northland Medical Center | Minneapolis-St. Paul MN | $4,800 | 1.4× | 4 | 2026-01-29 |
| M Health Fairview Ridges Hospital | Minneapolis-St. Paul MN | $4,800 | 1.4× | 4 | 2026-02-06 |
| HCA HealthONE Presbyterian/St. Luke's | Denver CO | $4,857 | 1.4× | 4 | 2026-09-01 |
| Anna Jaques Hospital | Boston MA | $4,933 | 1.2× | 3 | 2026-04-01 |
| Mercy Hospital St Louis | St. Louis MO | $4,953 | 1.5× | 1 | 2026-06-04 |
| Mercy Hospital Jefferson | St. Louis MO | $4,953 | 1.5× | 1 | 2026-06-10 |
| Mercy Hospital South | St. Louis MO | $4,953 | 1.5× | 1 | 2026-06-10 |
| Mercy Hospital Washington | St. Louis MO | $4,953 | 1.5× | 1 | 2026-06-10 |
| Hennepin County Medical Center | Minneapolis-St. Paul MN | $4,966 | 1.4× | 2 | 2025-12-17 |
| Uchealth Broomfield Hospital | Denver CO | $4,986 | 1.4× | 4 | 2025-11-01 |
| Reston Hospital Center | Washington DC | $4,988 | 1.4× | 4 | 2026-09-01 |
| Stonesprings Hospital Center | Washington DC | $4,995 | 1.5× | 4 | 2026-09-01 |
| Emory University Hospital | Atlanta GA | $5,024 | 1.5× | 6 | 2026-04-01 |
| Emory University Hospital Midtown | Atlanta GA | $5,024 | 1.5× | 6 | 2026-04-01 |
| Emory Saint Joseph's Hospital | Atlanta GA | $5,024 | 1.5× | 6 | 2026-04-01 |
| Emory Johns Creek Hospital | Atlanta GA | $5,024 | 1.5× | 6 | 2026-04-01 |
| Cleveland Clinic Hospital | Miami-Fort Lauderdale FL | $5,038 | 1.5× | 1 | 2026-06-15 |
| Emory Houston Hospital Warner Robins | Georgia (statewide) | $5,051 | 1.7× | 3 | 2026-04-01 |
| Houston Methodist Hospital | Houston TX | $5,052 | 1.5× | 6 | 2026-04-01 |
| Hca Houston Healthcare Southeast | Houston TX | $5,134 | 1.5× | 5 | 2026-09-01 |
| Hca Houston Healthcare Conroe | Houston TX | $5,134 | 1.5× | 5 | 2026-09-01 |
| Hca Houston Healthcare Northwest | Houston TX | $5,134 | 1.5× | 5 | 2026-09-01 |
| Hca Houston Healthcare Tomball | Houston TX | $5,134 | 1.5× | 5 | 2026-09-01 |
| Hca Houston Healthcare Kingwood | Houston TX | $5,134 | 1.5× | 5 | 2026-09-01 |
| Temple University Hospital | Philadelphia PA | $5,164 | 1.5× | 6 | 2026-04-13 |
| Providence Cedars Sinai Tarzana Medical Center | Los Angeles CA | $5,196 | 1.2× | 4 | 2026-04-01 |
| Providence Saint Joseph Medical Ctr | Los Angeles CA | $5,246 | 1.2× | 4 | 2026-04-01 |
| Henry Ford Health Hospital | Detroit MI | $5,280 | 1.6× | 2 | 2026-06-28 |
| Beth Israel Deaconess Medical Center | Boston MA | $5,348 | 1.4× | 2 | 2026-04-01 |
| Endeavor Health Elmhurst Hospital | Chicago IL | $5,363 | 1.5× | 2 | 2026-04-01 |
| Baylor Scott & White Medical Center - Lake Pointe | Dallas-Fort Worth TX | $5,409 | 1.6× | 3 | 2026-06-29 |
| Hca Houston Healthcare Medical Center | Houston TX | $5,422 | 1.6× | 5 | 2026-09-01 |
| Providence Holy Cross Medical Center | Los Angeles CA | $5,442 | 1.3× | 5 | 2026-04-01 |
| Tri-City Medical Center | San Diego CA | $5,452 | 1.3× | 4 | 2026-05-29 |
| Jefferson Abington Hospital | Philadelphia PA | $5,482 | 1.7× | 4 | 2026-09-15 |
| Denver Health Medical Center | Denver CO | $5,486 | 1.6× | 4 | 2026-04-30 |
| Spotsylvania Regional Medical Center | Washington DC | $5,498 | 1.6× | 3 | 2026-09-01 |
| Methodist Hospital | San Antonio TX | $5,500 | 1.6× | 5 | 2026-09-01 |
| Methodist Hospital Stone Oak | San Antonio TX | $5,500 | 1.6× | 5 | 2026-09-01 |
| Providence Little Co Of Mary Med Ctr San Pedro | Los Angeles CA | $5,615 | 1.3× | 4 | 2026-04-01 |
| Providence Little Company Of Mary Med Ctr Torrance | Los Angeles CA | $5,627 | 1.3× | 4 | 2026-04-01 |
| Upmc Washington | Pittsburgh PA | $5,644 | 1.8× | 2 | 2026-03-06 |
| Stony Brook University Hospital | New York (statewide) | $5,783 | 1.4× | 5 | 2026-06-10 |
| Harper University Hospital | Detroit MI | $5,812 | 1.8× | 1 | 2026-09-02 |
| Huron Valley-Sinai Hospital | Detroit MI | $5,812 | 1.8× | 1 | 2026-05-20 |
| Scott & White Hospital-Round Rock | Austin TX | $5,844 | 1.8× | 4 | 2026-06-13 |
| Baylor Scott & White Medical Center ? Pflugerville | Austin TX | $5,844 | 1.8× | 4 | 2026-06-13 |
| Baylor Scott & White Medical Center- Austin | Austin TX | $5,844 | 1.8× | 4 | 2026-06-13 |
| Endeavor Health Evanston Hospital | Chicago IL | $5,908 | 1.7× | 2 | 2026-04-01 |
| St David's Medical Center | Austin TX | $5,926 | 1.8× | 5 | 2026-09-01 |
| St David's South Austin Medical Center | Austin TX | $5,926 | 1.8× | 5 | 2026-09-01 |
| Round Rock Medical Center | Austin TX | $5,926 | 1.8× | 5 | 2026-09-01 |
| North Austin Medical Center | Austin TX | $5,926 | 1.8× | 5 | 2026-09-01 |
| Riddle Memorial Hospital | Philadelphia PA | $5,934 | 1.7× | 2 | 2026-04-01 |
| Medina Hospital | Cleveland OH | $5,944 | 1.9× | 1 | 2026-06-15 |
| UCHealth University of Colorado Hospital | Denver CO | $5,980 | 1.7× | 3 | 2025-11-01 |
| Morton Plant Hospital | Tampa FL | $6,037 | 1.7× | 2 | 2026-01-01 |
| Mease Dunedin Hospital | Tampa FL | $6,037 | 1.7× | 2 | 2026-01-01 |
| South Florida Baptist Hospital | Tampa FL | $6,037 | 1.7× | 2 | 2026-01-01 |
| Mease Countryside Hospital | Tampa FL | $6,037 | 1.7× | 2 | 2026-01-01 |
| Inova Alexandria Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Inova Loudoun Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Inova Fairfax Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Inova Fair Oaks Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Inova Mount Vernon Hospital | Washington DC | $6,158 | 1.8× | 5 | 2026-04-01 |
| Maimonides Medical Center | New York City | $6,160 | 1.5× | 5 | 2026-04-01 |
| Wellstar Kennestone Hospital | Atlanta GA | $6,179 | 1.8× | 5 | 2026-04-01 |
| Wellstar North Fulton Hospital | Atlanta GA | $6,179 | 1.9× | 5 | 2026-04-01 |
| Paoli Hospital | Philadelphia PA | $6,187 | 1.9× | 2 | 2026-04-01 |
| Medical City Weatherford | Dallas-Fort Worth TX | $6,208 | 1.9× | 5 | 2026-09-01 |
| Jefferson Health-Northeast | Philadelphia PA | $6,234 | 1.8× | 5 | 2026-09-15 |
| Jefferson Einstein Montgomery Hospital | Philadelphia PA | $6,234 | 1.9× | 5 | 2026-09-15 |
| Cleveland Clinic (main campus) | Cleveland OH | $6,238 | 2.0× | 3 | 2026-06-16 |
| Bryn Mawr Hospital | Philadelphia PA | $6,260 | 1.8× | 2 | 2026-04-01 |
| Lankenau Medical Center | Philadelphia PA | $6,328 | 2.0× | 2 | 2026-04-01 |
| Usc Verdugo Hills Hospital | Los Angeles CA | $6,632 | 1.6× | 4 | 2026-04-01 |
| Medical City Plano | Dallas-Fort Worth TX | $6,679 | 2.0× | 5 | 2026-09-01 |
| Baylor University Medical Center | Dallas-Fort Worth TX | $6,703 | 2.0× | 3 | 2026-06-29 |
| Baylor Scott & White Medical Center - Grapevine | Dallas-Fort Worth TX | $6,703 | 2.0× | 3 | 2026-06-29 |
| Baylor Scott & White Medical Center - McKinney | Dallas-Fort Worth TX | $6,703 | 2.0× | 3 | 2026-06-29 |
| Valley Regional Medical Center | Rio Grande Valley TX | $6,736 | 2.0× | 5 | 2026-09-01 |
| Rio Grande Regional Hospital | Rio Grande Valley TX | $6,736 | 2.0× | 5 | 2026-09-01 |
| Cleveland Clinic Lutheran Hospital | Cleveland OH | $6,791 | 2.2× | 1 | 2026-06-15 |
| Marymount Hospital | Cleveland OH | $6,791 | 2.2× | 1 | 2026-06-15 |
| CJW Medical Center (Chippenham + Johnston-Willis) | Richmond VA | $6,884 | 2.1× | 4 | 2026-09-01 |
| Henrico Doctors' Hospital | Richmond VA | $6,884 | 2.1× | 4 | 2026-09-01 |
| Tricities Hospital | Richmond VA | $6,884 | 2.1× | 4 | 2026-09-01 |
| Lutheran Medical Center | Denver CO | $6,896 | 2.0× | 6 | 2026-03-22 |
| Intermountain Health Saint Joseph Hospital | Denver CO | $6,896 | 2.0× | 6 | 2026-03-22 |
| Bethesda North | Ohio (statewide) | $7,016 | 2.2× | 4 | 2026-04-01 |
| Medical City Dallas | Dallas-Fort Worth TX | $7,124 | 2.1× | 5 | 2026-09-01 |
| Cleveland Clinic Hillcrest Hospital | Cleveland OH | $7,260 | 2.3× | 2 | 2026-06-15 |
| Cleveland Clinic Fairview Hospital | Cleveland OH | $7,260 | 2.3× | 2 | 2026-06-15 |
| Swedish Edmonds Hospital | Seattle-Tacoma WA | $7,277 | 2.0× | 5 | 2026-04-01 |
| Advocate Christ Medical Center | Chicago IL | $7,295 | 2.0× | 1 | 2025-11-04 |
| Advocate Lutheran General Hospital | Chicago IL | $7,295 | 2.0× | 1 | 2025-11-04 |
| Memorialcare Orange Coast Medical Center | Los Angeles CA | $7,368 | 1.7× | 5 | 2026-04-01 |
| Stanford Health Care Tri-Valley | San Francisco Bay Area CA | $7,494 | 1.6× | 4 | 2026-04-01 |
| University of Chicago Medical Center | Chicago IL | $7,543 | 2.1× | 2 | 2026-04-01 |
| Medical City Mckinney | Dallas-Fort Worth TX | $7,544 | 2.3× | 5 | 2026-09-01 |
| Jefferson Hospital | Pittsburgh PA | $7,600 | 2.4× | 5 | 2026-04-14 |
| Menorah Medical Center | Kansas (statewide) | $7,622 | 2.4× | 5 | 2026-09-01 |
| Santa Monica - Ucla Med Ctr & Orthopaedic Hospital | Los Angeles CA | $7,634 | 1.8× | 2 | 2026-03-29 |
| Allegheny Valley Hospital | Pittsburgh PA | $7,875 | 2.4× | 5 | 2026-04-14 |
| Montefiore Medical Center | New York City | $7,886 | 1.9× | 8 | 2026-04-01 |
| Medical City Denton | Dallas-Fort Worth TX | $7,910 | 2.4× | 5 | 2026-09-01 |
| Medical City Fort Worth | Dallas-Fort Worth TX | $8,094 | 2.4× | 5 | 2026-09-01 |
| Memorialcare Long Beach Medical Center | Los Angeles CA | $8,228 | 1.9× | 5 | 2026-04-01 |
| Ucla West Valley Medical Center | Los Angeles CA | $8,230 | 1.9× | 1 | 2026-03-29 |
| Intermountain Health Platte Valley Hospital | Denver CO | $8,381 | 2.4× | 3 | 2026-03-22 |
| Swedish Issaquah | Seattle-Tacoma WA | $8,472 | 2.2× | 5 | 2026-04-01 |
| Good Samaritan Hospital | San Francisco Bay Area CA | $8,740 | 1.8× | 6 | 2026-09-01 |
| Keck Hospital Of Usc | Los Angeles CA | $8,770 | 2.1× | 5 | 2026-04-01 |
| Forbes Hospital | Pittsburgh PA | $8,892 | 2.8× | 5 | 2026-04-14 |
| Jefferson Stratford Hospital | Philadelphia PA | $9,022 | 2.4× | 3 | 2026-09-15 |
| Providence Mission Hospital | Los Angeles CA | $9,333 | 2.2× | 5 | 2026-04-01 |
| Ahn Wexford Hospital | Pittsburgh PA | $9,484 | 2.9× | 5 | 2026-04-14 |
| Providence St. Joseph Hospital | Los Angeles CA | $9,532 | 2.2× | 5 | 2026-04-01 |
| Thomas Jefferson University Hospital | Philadelphia PA | $9,630 | 2.8× | 3 | 2026-09-15 |
| Texas Health Presbyterian Hospital Dallas | Dallas-Fort Worth TX | $9,693 | 2.9× | 2 | 2026-04-21 |
| Texas Health Presbyterian Hospital Plano | Dallas-Fort Worth TX | $9,693 | 2.9× | 2 | 2026-04-21 |
| St Anne Hospital | Seattle-Tacoma WA | $9,763 | 2.5× | 5 | 2026-02-28 |
| Providence St. Jude Medical Center | Los Angeles CA | $9,792 | 2.3× | 5 | 2026-04-01 |
| NYU Langone Hospitals (Orthopedic Hospital + Tisch files) | New York City | $9,887 | 2.4× | 7 | 2026-01-01 |
| Overlake Hospital Medical Center | Seattle-Tacoma WA | $9,893 | 2.6× | 5 | 2026-04-01 |
| St Clare Hospital | Seattle-Tacoma WA | $9,949 | 2.6× | 6 | 2026-02-28 |
| St Joseph Medical Center | Seattle-Tacoma WA | $9,949 | 2.6× | 6 | 2026-02-28 |
| St Francis Community Hospital | Seattle-Tacoma WA | $9,949 | 2.6× | 6 | 2026-02-28 |
| St Anthony Hospital | Seattle-Tacoma WA | $10,125 | 2.6× | 6 | 2026-02-28 |
| Allegheny General Hospital | Pittsburgh PA | $10,352 | 3.2× | 5 | 2026-04-14 |
| UT Southwestern William P. Clements Jr. University Hospital | Dallas-Fort Worth TX | $10,598 | 3.2× | 2 | 2026-03-10 |
| St Mary's Medical Center | San Francisco Bay Area CA | $10,814 | 2.3× | 5 | 2026-04-01 |
| Legacy Emanuel Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Good Samaritan Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Mount Hood Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Meridian Park Medical Center | Portland OR | $11,261 | 3.1× | 5 | 2026-04-01 |
| Legacy Salmon Creek Medical Center | Portland OR | $11,261 | 3.0× | 5 | 2026-04-01 |
| Swedish Medical Center / Cherry Hill | Seattle-Tacoma WA | $11,396 | 3.0× | 5 | 2026-04-01 |
| Swedish Medical Center | Seattle-Tacoma WA | $11,504 | 3.0× | 5 | 2026-04-01 |
| Mount Carmel East | Columbus OH | $11,925 | 3.7× | 19 | 2026-03-31 |
| Providence St Vincent Medical Center | Portland OR | $11,960 | 3.3× | 3 | 2026-04-01 |
| Providence Portland Medical Center | Portland OR | $11,960 | 3.3× | 3 | 2026-04-01 |
| Providence Milwaukie Hospital | Portland OR | $11,960 | 3.3× | 3 | 2026-04-01 |
| Lehigh Valley Hospital | Pennsylvania (statewide) | $12,530 | 3.7× | 8 | 2026-07-01 |
| Hoag Memorial Hospital Presbyterian | Los Angeles CA | $12,726 | 3.0× | 4 | 2026-04-01 |
| Tacoma General Allenmore Hospital | Seattle-Tacoma WA | $13,172 | 3.4× | 5 | 2026-08-27 |
| Multicare Auburn Medical Center | Seattle-Tacoma WA | $13,172 | 3.4× | 5 | 2026-08-27 |
| Multicare Covington Medical Center | Seattle-Tacoma WA | $13,172 | 3.4× | 5 | 2026-08-27 |
| Inspira Medical Center Mullica Hill | Philadelphia PA | $13,320 | 3.6× | 1 | 2026-03-24 |
| Los Robles Hospital & Medical Center | California (statewide) | $13,497 | 3.2× | 5 | 2026-09-01 |
| Uc San Diego Health Hillcrest - Hillcrest Med Ctr | San Diego CA | $13,704 | 3.2× | 4 | 2026-04-01 |
| Multicare Good Samaritan Hospital | Seattle-Tacoma WA | $14,151 | 3.7× | 4 | 2026-08-27 |
| Tampa General Hospital Brooksville | Tampa FL | $15,523 | 4.5× | 3 | 2026-04-01 |
| Stanford Health Care | San Francisco Bay Area CA | $22,041 | 4.5× | 3 | 2026-04-01 |
| John Muir Medical Center - Walnut Creek Campus | San Francisco Bay Area CA | $22,072 | 4.7× | 6 | 2026-03-23 |
| John Muir Medical Center - Concord Campus | San Francisco Bay Area CA | $22,072 | 4.7× | 6 | 2026-03-23 |
| Cedars-Sinai Medical Center | Los Angeles CA | $25,517 | 6.0× | 3 | 2025-11-26 |
Questions
How much do commercial insurers pay hospitals for tonsillectomy (age 12+)?
Across 257 hospitals in 38 metro areas that post a usable dollar rate, the median commercial rate for CPT 42826, hospital outpatient is $5,348, 1.5× the same hospital's local Medicare base rate. The middle half of hospitals runs $4,201 to $7,260. Figures are each hospital's median across insurers, from its federal price-transparency file.
What does Medicare pay for tonsillectomy (age 12+)?
Medicare's national hospital outpatient rate for CPT 42826 is $3,387 and its surgery-center rate is $1,480, before local wage adjustment.
Which hospitals post the lowest and highest commercial rates for tonsillectomy (age 12+)?
Lowest medians: Ascension Saint Thomas Rutherford ($2,307), South Shore Hospital ($2,408), Ascension Seton Medical Center Austin ($2,515). Highest: Cedars-Sinai Medical Center ($25,517), John Muir Medical Center - Concord Campus ($22,072), John Muir Medical Center - Walnut Creek Campus ($22,072). Coverage is limited to the markets listed on this page.