Average Medicaid Tonsillectomy Payments in Chicago, IL: $441.28
Avg. Paid
$441.28
Range
$178.02 – $2,825
Total Claims
2,056
Providers
16
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 Chicago, IL
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Paul John Jones
1611 W Harrison St |
$178.02 | 12 | 12 |
|
Jonathan Benjamin Ida
225 E Chicago Ave # 25 |
$210.64 | 13 | 13 |
|
Krupa Patel
1611 W Harrison St Ste 550 |
$201.64 | 14 | 12 |
|
Fuad Baroody
5841 S Maryland Ave |
$194.20 | 14 | 14 |
|
Kathryn L Colman
3000 N Halsted St |
$194.78 | 25 | 25 |
|
Stephen R Hoff
1740 W Taylor St |
$200.49 | 30 | 27 |
|
Jeff Charles Rastatter
225 E. Chicago Ave., #25 |
$208.96 | 55 | 53 |
|
John Maddalozzo
225 E. Chicago Ave., #25 |
$196.70 | 70 | 66 |
|
Anatoli Frances Karas
1611 W Harrison St Ste 550 |
$193.64 | 98 | 85 |
|
Kathleen Billings
225 E. Chicago Ave., #25 |
$204.15 | 141 | 138 |
|
Jennifer Lavin
676 N Saint Clair St |
$203.04 | 183 | 164 |
|
Henry Ford Health St. John Hospital
3187 Solutions Ctr |
$2,825 | 190 | 190 |
|
Saied Ghadersohi
225 E Chicago Ave # 25 |
$203.92 | 199 | 177 |
|
Andrea Shogan
5841 S Maryland Ave |
$186.90 | 215 | 212 |
|
Taher Valika
225 E Chicago Ave |
$200.22 | 339 | 268 |
|
Douglas R. Johnston
225 E Chicago Ave |
$197.53 | 458 | 358 |
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 Chicago, IL?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Chicago, IL is $441.28 per claim, based on 2,056 claims from 16 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 Chicago, IL?
There are 16 Medicaid providers offering Tonsillectomy related services in Chicago, IL according to public payment data.
What is the price range for Tonsillectomy in Chicago, IL?
Medicaid reimbursement for Tonsillectomy in Chicago, IL ranges from $178.02 to $2,825 per claim, with an average of $441.28. 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 Chicago, IL
Office Visit
Avg $30.31
13,989,780 claims
Blood Work & Lab Tests
Avg $5.03
10,887,691 claims
Dental Cleaning & Exam
Avg $29.66
4,929,791 claims
Emergency Room Visit
Avg $84.83
4,391,753 claims
Vaccines & Immunizations
Avg $3.36
3,818,199 claims
X-Ray
Avg $8.48
2,515,281 claims
Urinalysis & Urine Tests
Avg $2.23
2,467,995 claims
Substance Abuse Treatment
Avg $93.51
2,283,492 claims