How much does tonsillectomy & adenoidectomy, under 12 cost in Colorado?

CPT 42820 — the fair price, every hospital's price, and the Medicare benchmark for Colorado.

Estimates only. Educational estimates from public Medicare benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
42820 Tonsillectomy & adenoidectomy, under 12
Ask to pay
$11,831
About 2.0× what Medicare pays — most hospitals accept a self-pay rate in this range.
What Medicare paysⓘ
$5,916
Typical price near you
$6,381
Cash / self-pay price
$15,563
Prices near you — 37 facilities, lowest first
FacilityTypePricevs MedicareQuality
CommonSpirit St. Anthony Hospital (Lakewood) lowest ⚠ likely error Hospital $286negotiated 0.0× ★★★★★
CommonSpirit St. Mary-Corwin Hospital (Pueblo) ⚠ likely error Hospital $286negotiated 0.0× ★★★★★
CommonSpirit Penrose Hospital (Colorado Springs) ⚠ likely error Hospital $286negotiated 0.0× ★★★★★
CommonSpirit Mercy Hospital (Durango) ⚠ likely error Hospital $286negotiated 0.0× ★★★★★
CommonSpirit Longmont United Hospital ⚠ likely error Hospital $292negotiated 0.0× ★★★★★
Children's Hospital Colorado (Aurora) ⚠ likely error Hospital $371negotiated 0.1× —
Boulder Community Health Foothills Hospital (Boulder) ⚠ likely error Hospital $565negotiated 0.1× ★★★★★
Aspen Valley Hospital (Aspen) Hospital $1,562cash 0.3× —
UCHealth Pikes Peak Regional Hospital (Woodland Park) Hospital $4,673negotiated 0.8× —
UCHealth Highlands Ranch Hospital Hospital $5,515negotiated 0.9× ★★★★★
Community Hospital (Grand Junction) Hospital $5,599cash 0.9× ★★★★★
UCHealth Longs Peak Hospital (Longmont) Hospital $5,743negotiated 1.0× ★★★★★
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 7 unusually low/high prices excluded from the typical price as likely data errors.
💬 What to say — negotiation scripts
  • For 42820 (Tonsillectomy & adenoidectomy, under 12), Medicare's benchmark rate is $5,915.66. A fair self-pay target for this line is $11,831.32. If I was charged more than that, please reduce it toward this benchmark.
  • Your own published cash / self-pay price for 42820 is $15,563.00, and negotiated rates at nearby facilities run $5,093.78–$9,814.87. Please apply a rate in that range to my bill rather than the gross charge.
  • Please send a fully itemized bill listing every CPT/HCPCS/DRG code and its individual charge, so I can review each line against published rates.
  • Separately, what is your financial assistance / charity care policy, and am I eligible? Please send me the application and the income thresholds.
See tonsillectomy & adenoidectomy, under 12 prices in another area
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What should 42820 cost in Colorado?

For tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Colorado, a fair self-pay price is around $6,381, with hospitals ranging from $5,094 to $9,815 across 37 facilities. Medicare's benchmark rate is $5,916, the floor to negotiate toward. The card above lists each hospital's price, cheapest first, with CMS quality stars.

Frequently asked questions

How much does tonsillectomy & adenoidectomy, under 12 cost in Colorado?

A fair self-pay price for tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Colorado is around $6,381, with hospital prices ranging from $5,094 to $9,815 across 37 facilities. These are estimates from hospital-published prices, not a guarantee.

What is the Medicare rate for CPT 42820?

Medicare pays about $5,916 for tonsillectomy & adenoidectomy, under 12 (CPT 42820). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.

Can I negotiate the price of tonsillectomy & adenoidectomy, under 12?

Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.

Got a bill for this?

If you were charged more than the fair price, you can usually negotiate it down. Paste your itemized bill to get a personalized appeal letter, the exact numbers to cite, an AI negotiation coach, and a charity-care eligibility check — free.

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Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.