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Tonsillectomy (age 12+) in Missouri: what insurers pay

Posted commercial rates at 21 Missouri hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Mercy Hospital Joplin Joplin$1,8390.6×162026-06-09
Mercy Hospital Springfield Springfield$1,8390.6×182026-06-04
Mercy Hospital Jefferson Festus$2,9750.9×122026-06-10
Mercy Hospital Washington Washington$2,9750.9×122026-06-10
Nkc Health North Kansas City$3,2141.0×42026-03-06
Mercy Hospital St Louis Saint Louis$3,2341.0×122026-06-04
Mercy Hospital South Saint Louis$3,2341.0×132026-06-10
Saint Luke'S East Hospital Lees Summit$4,1001.2×52025-12-31
Northeast Regional Medical Center Kirksville$4,4461.3×32026-04-01
Freeman Neosho Hospital Neosho$4,8781.5×42026-09-01
Texas County Memorial Hospital Houston$5,0231.5×32026-04-21
Boone Hospital Center Columbia$5,0981.5×12026-04-01
Citizens Memorial Hospital Bolivar$5,1821.6×12026-03-25
St Joseph Medical Center Kansas City$6,1131.8×52026-03-17
Lafayette Regional Health Center Lexington$6,2951.9×22026-09-01
Saint Francis Medical Center Cape Girardeau$6,8862.1×32026-04-01
Lee'S Summit Medical Center Lees Summit$7,8292.4×62026-09-01
Belton Regional Medical Center Belton$7,8292.4×62026-09-01
Research Medical Center Kansas City$7,8802.4×62026-09-01
Centerpoint Medical Center Independence$7,9982.4×62026-09-01
Freeman Health System - Freeman West Joplin$9,2022.8×22026-09-01

Questions

How much do insurers pay for tonsillectomy (age 12+) in Missouri?

21 Missouri hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 21 hospitals is $5,023, 1.5× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.