Average Medicaid Tonsillectomy Payments in Aurora, CO: $915.09
Avg. Paid
$915.09
Range
$190.52 – $1,873
Total Claims
1,634
Providers
11
Typical Payment Range
Typical Medicaid Tonsillectomy payments fall between $206.59 and $1,054 per claim (median: $326.29). The top 10% of payments exceed $1,741.
Based on per-provider averages across all Medicaid claims in this category.
Surgical removal of the tonsils, commonly performed for recurrent tonsillitis or obstructive sleep apnea in children and adults.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Tonsillectomy in Aurora, CO
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Scott Edward Mann
13001 E 17Th Pl |
$193.40 | 13 | 12 |
|
Patricia Yoon
13123 E 16Th Ave |
$208.35 | 26 | 25 |
|
Allison Marie Dobbie
13123 E 16Th Ave |
$1,435 | 28 | 28 |
|
Soham Roy
13123 E 16Th Ave |
$725.93 | 57 | 51 |
|
Christian Ray Francom
13123 E 16Th Ave |
$664.13 | 60 | 56 |
|
Owen A. F. Darr
13123 E 16Th Ave |
$190.52 | 72 | 65 |
|
Stephen S Newton
13123 E 16Th Ave |
$1,873 | 143 | 142 |
|
Todd Wine
13123 E 16Th Ave |
$1,010 | 161 | 158 |
|
Jeremy Prager
13123 E 16Th Ave |
$498.76 | 216 | 205 |
|
Christopher M Discolo
13123 E 16Th Ave |
$730.86 | 424 | 403 |
|
Brian W. Herrmann
13123 E 16Th Ave |
$1,162 | 434 | 411 |
What to Expect: Tonsillectomy
A tonsillectomy takes about 30-45 minutes under general anesthesia. It's usually an outpatient procedure. Recovery takes 10-14 days. Throat pain is the most common complaint and can be managed with pain medication. A soft diet and plenty of fluids are recommended. Watch for signs of bleeding, which can occur up to 2 weeks after surgery.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 42820 | Tonsillectomy & adenoidectomy <12 | $1,012 | 494,505 | 1,624 |
| 42830 | Adenoidectomy primary <12 | $707.06 | 97,633 | 368 |
| 42821 | Tonsillectomy & adenoidect >12 | $1,047 | 2,603 | 42 |
| 42826 | Tonsillectomy primary >12 | $686.37 | 314 | 9 |
| 42825 | Tonsillectomy primary <12 | $426.12 | 147 | 4 |
| 42831 | Adenoidectomy primary >12 | — | — | — |
| 42835 | Adenoidectomy secondary <12 | — | — | — |
| 42836 | Adenoidectomy secondary >12 | — | — | — |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Tonsillectomy cost in Aurora, CO?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Aurora, CO is $915.09 per claim, based on 1,634 claims from 11 providers. Typical payments fall between $206.59 and $1,054. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Tonsillectomy in Aurora, CO?
There are 11 Medicaid providers offering Tonsillectomy related services in Aurora, CO according to public payment data.
What is the price range for Tonsillectomy in Aurora, CO?
Medicaid reimbursement for Tonsillectomy in Aurora, CO ranges from $190.52 to $1,873 per claim, with an average of $915.09. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Tonsillectomy in Other Cities
Knoxville, TN
Avg $425.33
14,943 claims · 6 providers
Phoenix, AZ
Avg $1,967
14,090 claims · 25 providers
St Petersburg, FL
Avg $144.73
13,997 claims · 6 providers
Nashville, TN
Avg $1,316
11,572 claims · 12 providers
Cincinnati, OH
Avg $805.15
10,929 claims · 18 providers
Birmingham, AL
Avg $378.75
10,761 claims · 6 providers
Columbus, OH
Avg $798.70
10,468 claims · 17 providers
Atlanta, GA
Avg $1,186
9,625 claims · 4 providers
Other Procedures in Aurora, CO
Office Visit
Avg $70.37
2,536,346 claims
Emergency Room Visit
Avg $123.06
1,707,782 claims
Non-Emergency Medical Transportation
Avg $69.09
1,231,085 claims
Blood Work & Lab Tests
Avg $7.65
1,185,130 claims
Dental Cleaning & Exam
Avg $33.08
1,057,520 claims
Home Health Visit
Avg $444.53
1,017,765 claims
Ambulance Transport
Avg $100.03
940,765 claims
Physical Therapy
Avg $35.35
817,799 claims