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Tonsillectomy (age 12+) in New York: what insurers pay

Posted commercial rates at 37 New York hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Bronxcare Hospital Center Bronx$2,5310.6×52026-05-05
Nassau University Medical Center East Meadow$2,5430.6×32025-10-28
LINCOLN MEDICAL & MENTAL HEALTH CENTER Bronx$3,5420.9×72026-09-05
Jacobi Medical Center Bronx$3,5420.9×72026-09-05
Elmhurst Hospital Center Elmhurst$3,5420.9×72026-09-05
South Brooklyn Health Brooklyn$3,5420.9×72026-09-05
Metropolitan Hospital Center New York$3,5420.9×72026-09-05
Kings County Hospital Center Brooklyn$3,5420.9×72026-09-05
Bellevue Hospital Center New York$3,5420.9×72026-09-05
Queens Hospital Center Jamaica$3,5420.9×72026-09-05
Harlem Hospital Center New York$3,5420.9×72026-09-05
Oneida Health Oneida$3,9961.0×72026-09-27
Jamaica Hospital Medical Center Jamaica$4,1181.0×102026-03-25
St Joseph'S Medical Center Yonkers$4,3961.1×22026-07-13
Wynn Hospital Utica$4,5111.1×152026-08-07
Garnet Health Medical Center Catskills Harris$4,6861.1×82026-04-01
Saratoga Hospital Saratoga Springs$4,9061.2×22025-12-31
Glens Falls Hospital Glens Falls$5,2991.3×42025-12-31
Garnet Health Medical Center Middletown$5,3861.3×92026-04-01
Columbia Memorial Hospital Hudson$5,4701.3×22025-12-31
Stony Brook University Hospital Stony Brook$5,7831.4×52026-06-10
Highland Hospital Rochester$5,9421.4×42026-07-01
Maimonides Medical Center Brooklyn$6,3971.6×72026-04-01
Montefiore Mount Vernon Hospital Mount Vernon$6,5241.6×102026-04-01
Erie County Medical Center Buffalo$6,5781.6×62026-08-25
Strong Memorial Hospital Rochester$7,1011.7×42026-07-01
Jones Memorial Hospital Wellsville$7,1121.7×72026-01-01
Geneva General Hospital Geneva$7,3021.8×32026-08-27
Crouse Hospital Syracuse$7,4331.8×32026-05-19
Nicholas H Noyes Memorial Hospital Dansville$8,4802.0×62026-01-01
Roswell Park Cancer Institute Buffalo$8,6322.1×32026-04-01
Samaritan Medical Center Watertown$8,7442.1×42026-02-02
Albany Medical Center Hospital Albany$8,9782.2×52025-12-31
NYU Langone Hospitals (Orthopedic Hospital + Tisch files) New York$9,2132.2×92026-01-01
St James Hospital Hornell$9,6722.3×62026-01-01
Medina Memorial Hospital Medina$10,1762.5×22026-07-29
Montefiore Medical Center Bronx$11,2632.7×132026-04-01

Questions

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

37 New York hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 37 hospitals is $5,386, 1.3× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.