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Package

Tonsil and adenoid removal (child under 12)

Package

Tonsil and adenoid removal (child under 12)

Tonsil and adenoid removal for children under 12 is surgery to remove the tonsils and adenoids in young children, most often recommended for frequent throat infections, difficulty breathing through the nose, or sleep problems like snoring or sleep apnea. The surgery is performed under general anesthesia and typically takes less than an hour, with most children going home the same day. Recovery usually takes one to two weeks, during which soft foods and pain management are important. Your child's doctor will provide specific instructions for at-home care during healing.
You'd pay up to
$11,549 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$11,549

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$5,480
Highest
$17,101
Cash price
up to $11,549

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Tonsil and adenoid removal (child under 12) Standard Service Package (SSP EN004). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS J1100 Facility Fee Intramuscular injection of 1mg dexamethasone sodium phosphate
HCPCS J2405 Facility Fee Intramuscular injection of ondansetron hydrochloride, 1mg
HCPCS 00170 Facility Fee Intraoral Anesthesia for Biopsy, Unspecified
HCPCS J2704 Facility Fee Intramuscular injection of 10mg propofol
HCPCS 69436 Facility Fee Ventilating Tube Insertion via Tympanostomy Under General Anesthesia
HCPCS 42830 Facility Fee Endoscopic Removal of Adenoids in Children Under 12
HCPCS 69436 Professional Fee Ventilating Tube Insertion via Tympanostomy Under General Anesthesia
HCPCS 42830 Professional Fee Endoscopic Removal of Adenoids in Children Under 12
Revenue Code 370 Facility Fee Anesthesia - General

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$11,549 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Tonsil and adenoid removal (child under 12)
Service Codes HCPCS J1100, HCPCS J2405, HCPCS 00170, HCPCS J2704, HCPCS 69436
Insurance I'm not using insurance
Location Southern Ohio Medical Center
When you contact us, you can say:
"Hi, I'm calling to verify a price for Tonsil and adenoid removal (child under 12) I found through Southern Ohio Medical Center's price estimate tool. Here are the codes I’m looking at: HCPCS J1100, HCPCS J2405, HCPCS 00170, HCPCS J2704, HCPCS 69436. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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