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

Posted commercial rates at 34 Wisconsin hospitals, each next to its own Medicare base rate.

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CPT 42826

HospitalMedian across insurers× MedicareInsurersFile date
Westfields Hospital And Clinic New Richmond$2,6000.8×12026-03-31
Orthopaedic Hospital Of Wisconsin Glendale$4,7441.4×32026-01-01
Gundersen St Josephs Hospital And Clinics Hillsboro$5,1401.6×22026-06-27
Marshfield Medical Center - Beaver Dam Beaver Dam$5,3881.7×12026-02-20
Froedtert Holy Family Memorial Hospital Manitowoc$5,7961.8×32025-12-31
Watertown Regional Medical Center Watertown$5,9071.8×12026-04-01
Marshfield Medical Center - Eau Claire Eau Claire$5,9131.8×32026-02-20
Marshfield Medical Center - Minocqua Minocqua$5,9131.8×32026-02-20
Froedtert Menomonee Falls Hospital Menomonee Falls$5,9241.8×42025-12-31
Hudson Hospital & Clinic Hudson$5,9871.7×12026-03-31
Unitypoint Health - Meriter Madison$6,0261.9×12026-01-28
Bellin Memorial Hospital Green Bay$6,1181.9×42026-06-27
Gundersen Lutheran Medical Center La Crosse$6,2181.9×32026-06-27
Froedtert Community Hospital New Berlin$6,4141.9×42025-12-31
Froedtert West Bend Hospital West Bend$6,5572.0×42025-12-31
Marshfield Medical Center Marshfield$6,7662.1×12026-02-20
Aurora Medical Ctr Manitowoc County Two Rivers$7,6512.4×142025-11-21
Aurora Medical Center Sheboygan County Sheboygan$7,6512.4×142025-11-21
Aurora Medical Ctr Washington County Hartford$7,6512.3×142025-11-21
Aurora Medical Center Burlington Burlington$7,6512.3×142025-11-21
Aurora Lakeland Medical Center Elkhorn$7,6512.4×142025-11-21
Aurora Medical Center Bay Area Marinette$7,6512.4×142025-11-21
Aurora West Allis Medical Center West Allis$7,6512.3×142025-11-21
Aurora Medical Ctr Kenosha Kenosha$7,6512.4×142025-11-21
Aurora Baycare Medical Ctr Green Bay$7,6512.4×142025-11-21
Aurora Medical Ctr Oshkosh Oshkosh$7,6512.4×142025-11-21
Aurora Medical Center Summit Summit$7,6512.3×142025-11-21
Aurora Medical Center Grafton$7,6512.3×142025-11-21
Aspirus Divine Savior Hospital Portage$9,5203.0×42026-04-01
Aspirus Wausau Hospital Wausau$9,8563.1×22026-04-01
Aspirus Stevens Point Hospital Stevens Point$12,9984.0×22026-04-01
Aspirus Rhinelander Hospital Rhinelander$12,9984.0×22026-04-01
Aspirus Wisconsin Rapids Hospital Wisconsin Rapids$12,9984.0×22026-04-01
Howard Young Medical Ctr Woodruff$12,9984.0×22026-04-01

Questions

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

34 Wisconsin hospitals post usable commercial rates for tonsillectomy (age 12+) in their federal price-transparency files. For CPT 42826, hospital outpatient, the median across 34 hospitals is $7,651, 2.3× each hospital's local Medicare base rate. Your share depends on your plan's deductible and coinsurance; the surgeon and anesthesia bill separately.