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

Posted commercial rates at 49 Texas hospitals, each next to its own Medicare base rate.

Open in the explorerAll statesEvery bill for the whole procedure

CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Ascension Seton Medical Center Austin Austin$2,5150.8×12026-01-01
Dell Seton Med Center At The University Of Tx Austin$2,5150.8×12026-01-01
Ascension Seton Southwest Austin$2,5150.8×12026-01-01
Ascension Seton Northwest Austin$2,5150.8×12026-01-01
Cedar Park Regional Medical Center Cedar Park$2,5150.8×12026-01-01
Ascension Seton Hays Kyle$2,5150.8×12026-01-01
Harlingen Medical Center Harlingen$3,7461.1×32026-09-01
University Health System San Antonio$3,7881.1×42025-10-14
Baylor St. Luke's Medical Center Houston$3,8121.1×72026-02-28
Houston Methodist Baytown Hospital Baytown$4,2011.3×62026-04-01
Houston Methodist Sugar Land Hospital Sugar Land$4,2011.3×62026-04-01
Houston Methodist West Hospital Houston$4,2011.3×62026-04-01
Houston Methodist The Woodlands Hospital The Woodlands$4,2011.3×62026-04-01
St. Luke's Health Sugar Land Hospital Sugar Land$4,2551.3×72026-02-28
Chi St Luke's Health Brazosport Lake Jackson$4,3281.3×42026-02-28
St. Luke's Health The Woodlands Hospital The Woodlands$4,3801.3×72026-02-28
Hca Houston Healthcare Clear Lake Webster$4,7411.4×52026-09-01
Doctors Hospital at Renaissance Edinburg$4,7591.4×22026-04-01
Houston Methodist Hospital Houston$5,0521.5×62026-04-01
Hca Houston Healthcare Southeast Pasadena$5,1341.5×52026-09-01
Hca Houston Healthcare Conroe Conroe$5,1341.5×52026-09-01
Hca Houston Healthcare Northwest Houston$5,1341.5×52026-09-01
Hca Houston Healthcare Tomball Tomball$5,1341.5×52026-09-01
Hca Houston Healthcare Kingwood Kingwood$5,1341.5×52026-09-01
Baylor Scott & White Medical Center - Lake Pointe Rowlett$5,4091.6×32026-06-29
Hca Houston Healthcare Medical Center Houston$5,4221.6×52026-09-01
Methodist Hospital San Antonio$5,5001.6×52026-09-01
Methodist Hospital Stone Oak San Antonio$5,5001.6×52026-09-01
Scott & White Hospital-Round Rock Round Rock$5,8441.8×42026-06-13
Baylor Scott & White Medical Center ? Pflugerville Pflugerville$5,8441.8×42026-06-13
Baylor Scott & White Medical Center- Austin Austin$5,8441.8×42026-06-13
St David's Medical Center Austin$5,9261.8×52026-09-01
St David's South Austin Medical Center Austin$5,9261.8×52026-09-01
Round Rock Medical Center Round Rock$5,9261.8×52026-09-01
North Austin Medical Center Austin$5,9261.8×52026-09-01
Medical City Weatherford Weatherford$6,2081.9×52026-09-01
Medical City Plano Plano$6,6792.0×52026-09-01
Baylor University Medical Center Dallas$6,7032.0×32026-06-29
Baylor Scott & White Medical Center - Grapevine Grapevine$6,7032.0×32026-06-29
Baylor Scott & White Medical Center - McKinney Mc Kinney$6,7032.0×32026-06-29
Valley Regional Medical Center Brownsville$6,7362.0×52026-09-01
Rio Grande Regional Hospital McAllen$6,7362.0×52026-09-01
Medical City Dallas Dallas$7,1242.1×52026-09-01
Medical City Mckinney McKinney$7,5442.3×52026-09-01
Medical City Denton Denton$7,9102.4×52026-09-01
Medical City Fort Worth Fort Worth$8,0942.4×52026-09-01
Texas Health Presbyterian Hospital Dallas Dallas$9,6932.9×22026-04-21
Texas Health Presbyterian Hospital Plano Plano$9,6932.9×22026-04-21
UT Southwestern William P. Clements Jr. University Hospital Dallas$10,5983.2×22026-03-10

Questions

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

49 Texas hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 49 hospitals is $5,409, 1.6× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.