How much does tonsillectomy & adenoidectomy, under 12 cost in Provo, UT?
CPT 42820 — the fair price, every hospital's price, and the Medicare benchmark for Provo, UT.
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Holy Cross Hospital - Mountain Point (Lehi) lowest ⚠ likely error | Hospital | $341negotiated | 0.1× | — |
| Moab Regional Hospital (Moab) ⚠ likely error | Hospital | $596cash | 0.1× | — |
| Intermountain Utah Valley Hospital (Provo) | Hospital | $3,958negotiated | 0.7× | ★★★★★ |
| Intermountain American Fork Hospital (American Fork) | Hospital | $3,958negotiated | 0.7× | ★★★★★ |
| Mountain View Hospital (Payson) | Hospital | $5,423negotiated | 0.9× | ★★★★★ |
| Timpanogos Regional Hospital (Orem) | Hospital | $5,528negotiated | 0.9× | ★★★★★ |
| Castleview Hospital (Price) | Hospital | $8,459cash | 1.4× | ★★★★★ |
- For 42820 (Tonsillectomy & adenoidectomy, under 12), Medicare's benchmark rate is $5,915.66. A fair self-pay target for this line is $4,527.59. If I was charged more than that, please reduce it toward this benchmark.
- Your own published cash / self-pay price for 42820 is $4,527.59, and negotiated rates at nearby facilities run $595.97–$5,528.00. 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.
What should 42820 cost in Provo, UT?
For tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Provo, UT, a fair self-pay price is around $5,423, with hospitals ranging from $596 to $5,528 across 7 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 Provo, UT?
A fair self-pay price for tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Provo, UT is around $5,423, with hospital prices ranging from $596 to $5,528 across 7 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.
Compare other procedures in Provo, UT
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.