Dilation of nasal sinus using an endoscope
Medicare pricing data for 1,304 providers across 42 states
Prices vary significantly by location — from $1,282 in Wisconsin to $2,697 in District of Columbia. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Dilation of nasal sinus using an endoscope (HCPCS code 31295) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $2,092, but hospitals typically charge $7,527 — a 3.6x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $2,092, your out-of-pocket cost would be approximately $418.33. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.6x more than what Medicare allows for this procedure. Medicare actually pays $1,667 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $2,697 | $6,699 | 3 | 47 | +28.9% |
| Maine | $2,534 | $5,131 | 1 | 22 | +21.1% |
| New Jersey | $2,475 | $9,559 | 25 | 137 | +18.3% |
| Hawaii | $2,462 | $4,536 | 2 | 32 | +17.7% |
| Connecticut | $2,443 | $13,698 | 19 | 190 | +16.8% |
| California | $2,425 | $6,179 | 115 | 1,836 | +15.9% |
| New York | $2,357 | $11,634 | 79 | 495 | +12.7% |
| Maryland | $2,339 | $6,943 | 25 | 223 | +11.8% |
| Rhode Island | $2,254 | $5,537 | 3 | 11 | +7.8% |
| Colorado | $2,246 | $7,109 | 17 | 108 | +7.4% |
| Massachusetts | $2,224 | $9,811 | 20 | 69 | +6.3% |
| Washington | $2,216 | $6,751 | 8 | 51 | +5.9% |
| Pennsylvania | $2,185 | $8,268 | 29 | 146 | +4.5% |
| Nevada | $2,183 | $6,499 | 15 | 471 | +4.4% |
| Oregon | $2,168 | $6,027 | 9 | 68 | +3.7% |
| Florida | $2,161 | $7,490 | 152 | 1,196 | +3.3% |
| Missouri | $2,129 | $6,722 | 18 | 280 | +1.8% |
| Georgia | $2,122 | $8,435 | 60 | 304 | +1.4% |
| Arizona | $2,076 | $6,882 | 34 | 1,062 | -0.8% |
| Texas | $2,063 | $8,195 | 176 | 1,802 | -1.4% |
| Oklahoma | $2,063 | $6,285 | 5 | 164 | -1.4% |
| North Carolina | $2,026 | $7,678 | 43 | 219 | -3.2% |
| Ohio | $2,019 | $6,214 | 17 | 147 | -3.5% |
| Utah | $2,004 | $6,641 | 17 | 43 | -4.2% |
| New Mexico | $1,991 | $5,635 | 3 | 17 | -4.8% |
| Alabama | $1,987 | $5,223 | 24 | 221 | -5.0% |
| West Virginia | $1,980 | $7,119 | 2 | 13 | -5.4% |
| Idaho | $1,979 | $8,459 | 3 | 22 | -5.4% |
| Tennessee | $1,946 | $10,343 | 35 | 169 | -7.0% |
| Kansas | $1,945 | $4,505 | 9 | 51 | -7.0% |
| Louisiana | $1,939 | $7,159 | 23 | 245 | -7.3% |
| South Carolina | $1,932 | $5,767 | 19 | 219 | -7.6% |
| Mississippi | $1,899 | $11,534 | 17 | 151 | -9.2% |
| Arkansas | $1,893 | $9,249 | 5 | 17 | -9.5% |
| Virginia | $1,875 | $6,256 | 44 | 352 | -10.4% |
| Indiana | $1,819 | $7,593 | 24 | 374 | -13.0% |
| Illinois | $1,818 | $8,080 | 67 | 678 | -13.1% |
| Iowa | $1,812 | $8,188 | 13 | 49 | -13.4% |
| Kentucky | $1,793 | $4,795 | 18 | 82 | -14.3% |
| Michigan | $1,765 | $5,114 | 37 | 146 | -15.6% |
| Minnesota | $1,548 | $8,719 | 18 | 121 | -26.0% |
| Wisconsin | $1,282 | $7,703 | 37 | 469 | -38.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber