Tonsillectomy (under age 12) at Children's National Hospital pediatric hospital
111 Michigan Avenue Nw, Washington, DC 20010. From the hospital's federally required price file (v3.0.0), file date April 2, 2026 — source file. Last verified by PriceCheck: July 16, 2026. CPT 42820.
Median commercial rate here: $480 — 90% below the Washington, DC metro median of $4,646. Compare all Washington, DC hospitals →
Commercial insurance plans
| Payer / plan | Facility rate | Rate type |
|---|---|---|
| Blue Cross Blue Shield Of Maryland (Carefirst)HMO | $290 | negotiated rate |
| Blue Cross Blue Shield Of Maryland (Carefirst)Rpn | $322 | negotiated rate |
| AetnaCommercial | $343 | negotiated rate |
| Blue Cross Blue Shield Of Virginia (Anthem)Hmx | $441 | negotiated rate |
| Blue Cross Blue Shield Of Virginia (Anthem)HMO | $480 | negotiated rate |
| Blue Cross Blue Shield Of Virginia (Anthem)PPO/Par | $600 | negotiated rate |
| CignaOap (+1 same-rate plans) | $692 | negotiated rate |
| Johns Hopkins HealthcareEHP | $830 | negotiated rate |
| Kaiser Foundation Health PlanCommercial | $830 | negotiated rate |
Medicaid plans
| Payer / plan | Facility rate | Rate type |
|---|---|---|
| Aetna Better Health MdManaged Medicaid | $231 | negotiated rate |
| Amerigroup MdManaged Medicaid | $231 | negotiated rate |
| United HealthcareManaged Medicaid | $252 | negotiated rate |
| Blue Cross Blue Shield Of Virginia (Anthem)Medicaid | $258 | negotiated rate |
| Blue Cross Blue Shield Of Maryland (Carefirst)Managed Medicaid | $278 | negotiated rate |
| Kaiser Foundation Health PlanManaged Medicaid | $278 | negotiated rate |
| Aetna Better Health VaManaged Medicaid | $291 | negotiated rate |
| Sentara Health PlansManaged Medicaid | $291 | negotiated rate |
| Medstar Family ChoiceManaged Medicaid | $316 | negotiated rate |
| Amerihealth DcManaged Medicaid | $324 | negotiated rate |
| Amerigroup DcManaged Medicaid | $392 | negotiated rate |
Common questions
How much does tonsillectomy (under age 12) cost at Children's National Hospital without insurance?
Children's National Hospital's price file lists a discounted cash (self-pay) facility rate of $692 for Tonsillectomy (under age 12), against a gross charge of $1,383. Facility rate only — physician, anesthesia, radiology, and pathology services bill separately.
What do insurance plans pay for tonsillectomy (under age 12) at Children's National Hospital?
Children's National Hospital lists 9 commercial plan rates for Tonsillectomy (under age 12), from $290 (Blue Cross Blue Shield Of Maryland (Carefirst)) to $830 (Kaiser Foundation Health Plan), with a median of $480. The Washington, DC metro median commercial rate for this procedure is $4,646.
Where do these prices come from?
Directly from the machine-readable file Children's National Hospital publishes under the CMS Hospital Price Transparency rule (45 CFR Part 180), file date April 2, 2026. These are price disclosures, not quotes.
Same procedure at nearby hospitals: The George Washington University Hospital · Virginia Hospital Center Arlington Health System · Inova Fairfax Hospital · Howard University Hospital Corp · Sibley Memorial Hospital