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

Posted commercial rates at 12 Ohio hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
University Hospitals - Elyria Medical Center Elyria$3,1741.0×42026-07-14
University Hospitals St. John Medical Center Westlake$3,4021.1×42026-07-14
MetroHealth System Cleveland$3,6191.1×42026-04-01
University Hospitals Ahuja Medical Center Beachwood$4,7741.5×12026-07-14
Medina Hospital Medina$5,9441.9×12026-06-15
Cleveland Clinic (main campus) Cleveland$6,2382.0×32026-06-16
Cleveland Clinic Lutheran Hospital Cleveland$6,7912.2×12026-06-15
Marymount Hospital Garfield Heights$6,7912.2×12026-06-15
Bethesda North Cincinnati$7,0162.2×42026-04-01
Cleveland Clinic Hillcrest Hospital Mayfield Heights$7,2602.3×22026-06-15
Cleveland Clinic Fairview Hospital Cleveland$7,2602.3×22026-06-15
Mount Carmel East Columbus$11,9253.7×192026-03-31

Questions

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

12 Ohio hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 12 hospitals is $6,515, 2.1× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.