Tonsillectomy and adenoidectomy, under age 12CPT 42820General surgery
Median commercial negotiated rate by hospital, from each hospital's own disclosure file.
The same procedure spans a 3.9× price range across 31 Colorado hospitals.
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— filter by insurer or region, map it, or compare hospitals side by side.
How to read “% of Medicare”
Medicare’s payment is a hospital-specific benchmark built from CMS files — adjusted for local wages
and case complexity, and roughly pegged to the cost of care. A commercial rate at 300% means a private plan pays
about triple that benchmark for the same care at the same hospital. The gap is negotiation, not quality.
Full methodology →
Median commercial negotiated rateMedicare benchmark
Kansas City Orthopaedic Institute $13,513vsNmc Health $3,462 what you pay what your plan pays
Deductible not metearly in the plan year
Kansas City Orthopaedic Institute
Nmc Health
$10,052you feel all of it
Deductible met20% coinsurance
Kansas City Orthopaedic Institute
Nmc Health
$2,010$8,041 invisible to you
Out-of-pocket max reacheda bad year, or a big surgery
Kansas City Orthopaedic Institute
Nmc Health
$0the market goes blind
The gap is $10,052 in every row. The only thing that changes is how much of it
reaches the person choosing. Nobody hid the price — the deductible structure hides the difference,
and a difference nobody feels is a difference nobody shops. Illustration uses a
20% coinsurance plan with no separate facility or professional bill; your own plan governs.
Detail (click headers to sort, or “why” for cost vs price)
*Cost estimates use hospital-level cost-to-charge ratios from federal cost reports and are approximate;
~ marks categories (imaging, labs) where they are least precise. "Plan rows" is how many distinct plan rates the
hospital published; medians over more rows are sturdier.
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Rexroad Analytics · Data: hospital machine-readable files (45 CFR 180, schema v3.0) retrieved August 21–22, 2026;
Medicare benchmarks from CMS claims data and fee schedules; cost estimates from FY2026 CMS cost-report ratios, labeled as estimates.
Not medical, legal, or benefits advice. Full methodology →
· The American Healthcare Conundrum →