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

Posted commercial rates at 52 Pennsylvania hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Upmc Mercy Pittsburgh$2,3850.7×22026-03-06
Upmc Bedford Memorial Everett$2,4970.8×22026-03-06
St Mary Medical Center Langhorne$2,5040.8×202026-03-31
Upmc Northwest Seneca$3,0760.9×22026-03-06
Upmc East Monroeville$3,3411.0×22026-03-06
Upmc Altoona Altoona$3,3841.1×12026-03-06
Temple Health - Chestnut Hill Hospital Philadelphia$3,7771.1×62026-04-08
Upmc Hamot Erie$4,0581.3×42026-03-06
Jefferson Hospital Jefferson Hills$4,1581.3×72026-04-14
Upmc Somerset Somerset$4,1741.3×22026-03-06
Saint Vincent Hospital Erie$4,3781.4×72026-04-14
Holy Redeemer Hospital And Medical Center Meadowbrook$4,9621.5×52026-09-21
Temple University Hospital Philadelphia$5,1641.5×92026-04-13
St Luke'S Hospital - Upper Bucks Campus Quakertown$5,2271.6×32026-02-26
Jefferson Lansdale Hospital Lansdale$5,5271.7×52026-09-15
Upmc Washington Washington$5,5271.7×42026-03-06
Jefferson Abington Hospital Abington$5,5271.7×52026-09-15
Riddle Memorial Hospital Media$5,9341.7×22026-04-01
Wellspan Evangelical Community Hospital Lewisburg$5,9791.9×62026-01-01
Uniontown Hospital Uniontown$6,1501.9×42026-07-09
Paoli Hospital Paoli$6,1871.9×22026-04-01
Bryn Mawr Hospital Bryn Mawr$6,2601.8×22026-04-01
Lankenau Medical Center Wynnewood$6,3282.0×22026-04-01
Wellspan York Hospital York$6,4202.0×32026-01-01
Allegheny Valley Hospital Natrona$6,5862.0×62026-04-14
Canonsburg General Hospital Canonsburg$6,6022.0×62026-04-14
Grove City Hospital Grove City$6,6362.1×52026-04-14
Forbes Hospital Monroeville$6,7862.1×62026-04-14
Jefferson Health-Northeast Philadelphia$6,9122.0×62026-09-15
Jefferson Einstein Montgomery Hospital East Norriton$6,9122.1×62026-09-15
Upmc Hanover Hanover$6,9712.1×32026-03-06
Upmc Memorial York$7,0742.2×52026-03-06
Ahn Wexford Hospital Wexford$7,1022.2×62026-04-14
St Clair Hospital Pittsburgh$7,4102.3×72026-03-31
St Luke'S Hospital - Monroe Campus Stroudsburg$8,0502.5×32026-02-27
Allegheny General Hospital Pittsburgh$8,1632.5×62026-04-14
St Luke'S Hospital Bethlehem Bethlehem$8,1952.4×32026-02-26
St Luke'S Hospital - Carbon Campus Lehighton$8,1952.4×32026-02-27
West Penn Hospital Pittsburgh$8,2012.5×62026-04-14
Geisinger St. Luke'S Hospital Orwigsburg$8,7682.7×22026-02-26
Thomas Jefferson University Hospital Philadelphia$10,3653.0×42026-09-15
Wellspan Ephrata Community Hospital Ephrata$10,6923.3×22026-01-01
Penn State Health Hampden Medical Center Enola$11,0793.3×12026-03-27
Penn State Health Holy Spirit Medical Center Camp Hill$11,2013.4×12026-03-27
Penn State Health Lancaster Medical Center Lancaster$11,3753.5×12026-03-27
Lehigh Valley Hospital Allentown$12,5303.7×82026-07-01
Wellspan Chambersburg Hospital Chambersburg$13,1584.0×22026-01-01
Penn State Health St. Joseph Reading$14,6624.3×12026-03-27
Lehigh Valley Hospital - Dickson City Dickson City$14,6884.5×82026-07-01
Lehigh Valley Hospital - Hazleton Hazleton$15,2384.7×82026-07-01
Lehigh Valley Hospital - Pocono East Stroudsburg$15,9244.9×82026-07-01
Lehigh Valley Hospital - Macungie Macungie$15,9424.7×82026-07-01

Questions

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

52 Pennsylvania hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 52 hospitals is $6,619, 2.0× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.