00160

Anesthesia for other procedure on nose and sinuses

Medicare pricing data for 28,494 providers across 52 states

🤖AI Overview

This procedure has a 10.1x markup — hospitals charge $1,669 but Medicare allows only $165.91. Uninsured patients may face bills 10.1 times higher than what insurance negotiates. Prices vary significantly by location — from $111 in Alabama to $296 in Alaska. 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

Anesthesia for other procedure on nose and sinuses (HCPCS code 00160) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $165.91, but hospitals typically charge $1,669 — a 10.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$33.18

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $165.91, your out-of-pocket cost would be approximately $33.18. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$165.91
Average Hospital Charge
$1,669
Markup Ratio
10.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,669.06
Medicare Allowed$165.91
Medicare Payment$130.41

Hospitals charge 10.1x more than what Medicare allows for this procedure. Medicare actually pays $130.41 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$296$1,81161122+78.4%
Puerto Rico$282$1,4261931+70.2%
California$236$1,8001,8634,042+42.0%
Montana$225$1,328103259+35.7%
Nevada$212$2,069128308+27.9%
Hawaii$211$1,38270135+27.2%
Oregon$211$1,336304625+27.1%
Utah$210$1,200277584+26.9%
Idaho$210$1,304134266+26.4%
Washington$207$1,4916461,387+24.9%
Wyoming$202$1,29844118+22.0%
Nebraska$202$1,274266581+21.5%
New York$201$2,4911,2682,228+21.4%
New Mexico$200$1,850148236+20.7%
Iowa$199$1,284287584+19.7%
Arizona$195$2,0235031,550+17.8%
Maryland$194$1,804396896+16.9%
Oklahoma$189$1,562339800+13.7%
Colorado$186$1,7445381,068+11.9%
Illinois$184$2,0261,0892,053+11.2%
Louisiana$182$1,476470982+10.0%
New Jersey$181$1,9635531,047+9.1%
Arkansas$178$1,130232588+7.5%
Delaware$175$1,518108260+5.7%
District of Columbia$174$1,63788162+4.7%
Indiana$170$1,3926011,433+2.7%
Massachusetts$170$1,4527661,636+2.3%
Florida$167$1,8471,8624,321+0.4%
Kentucky$166$1,398395797-0.2%
Vermont$157$1,0244670-5.7%
Texas$154$2,0612,2515,867-6.9%
Tennessee$153$1,5788242,102-7.6%
Virginia$149$1,7886841,518-9.9%
Missouri$148$1,3747661,585-10.5%
Ohio$148$1,2581,3492,642-10.8%
Mississippi$148$962256825-10.9%
Connecticut$148$1,910303585-11.1%
Maine$145$1,542170273-12.5%
Pennsylvania$145$1,4461,5613,256-12.8%
Kansas$145$1,5714011,466-12.8%
North Dakota$144$1,191132223-13.1%
New Hampshire$142$2,131142282-14.4%
Michigan$142$1,8801,0882,008-14.5%
Wisconsin$142$2,1856941,186-14.7%
Minnesota$141$1,3776391,317-15.0%
West Virginia$140$1,195180349-15.4%
Georgia$138$1,6019892,352-16.8%
North Carolina$130$1,6311,0532,483-21.3%
South Carolina$129$1,5595711,887-22.2%
South Dakota$126$1,096166320-24.1%
Rhode Island$112$83749118-32.3%
Alabama$111$1,0465871,810-33.4%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber