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

Posted commercial rates at 30 Virginia hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Sentara Martha Jefferson Hospital Charlottesville$5,1461.6×42026-04-01
Sentara Northern Virginia Medical Center Woodbridge$5,4881.6×42026-04-01
Spotsylvania Regional Medical Center Fredericksburg$5,4981.6×52026-09-01
Inova Alexandria Hospital Alexandria$5,8661.7×72026-04-01
Inova Loudoun Hospital Leesburg$5,8661.7×72026-04-01
Inova Fairfax Hospital Falls Church$5,8661.7×72026-04-01
Inova Fair Oaks Hospital Fairfax$5,8661.7×72026-04-01
Inova Mount Vernon Hospital Alexandria$5,8661.7×72026-04-01
Reston Hospital Center Reston$6,8222.0×62026-09-01
Stonesprings Hospital Center Dulles$6,8222.0×62026-09-01
CJW Medical Center (Chippenham + Johnston-Willis) Richmond$6,8842.1×62026-09-01
Henrico Doctors' Hospital Richmond$6,8842.1×62026-09-01
Augusta Health Fishersville$7,0612.2×32026-04-01
Fauquier Hospital Warrenton$7,2682.1×12026-07-14
Tricities Hospital Hopewell$8,1372.5×52026-09-01
Lewisgale Hospital Montgomery Blacksburg$8,4032.6×32026-09-01
Lewisgale Hospital Pulaski Pulaski$8,4032.6×32026-09-01
Lewisgale Hospital Alleghany Low Moor$8,4032.6×32026-09-01
Riverside Regional Medical Center Newport News$9,0502.8×32026-01-02
Lewisgale Medical Center Salem$9,0602.8×22026-09-01
Sentara Leigh Hospital Norfolk$9,4282.9×32026-04-01
Sentara Virginia Beach General Hospital Virginia Beach$10,1743.1×32026-04-01
Sentara Rmh Medical Center Harrisonburg$10,2013.1×12026-04-01
Sentara Princess Anne Hospital Virginia Beach$10,7823.3×32026-04-01
Sentara Norfolk General Hospital Norfolk$10,9893.4×32026-04-01
Riverside Doctors' Hospital Of Williamsburg Williamsburg$11,2753.5×22026-01-02
Sentara Careplex Hospital Hampton$11,7293.6×22026-04-01
Sentara Williamsburg Regional Medical Center Williamsburg$12,2123.8×22026-04-01
Sentara Obici Hospital Suffolk$12,5783.9×32026-04-01
Riverside Shore Memorial Hospital Onancock$13,6234.2×12026-01-02

Questions

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

30 Virginia hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 30 hospitals is $8,270, 2.6× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.