30801

Destruction of soft tissue of nasal passages

Medicare pricing data for 978 providers across 43 states

🤖AI Overview

Prices vary significantly by location — from $69 in Vermont to $199 in California. Where you get this procedure matters more than almost any other factor. This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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

Destruction of soft tissue of nasal passages (HCPCS code 30801) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $148.96, but hospitals typically charge $555.84 — a 3.7x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$29.79

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $148.96, your out-of-pocket cost would be approximately $29.79. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$148.96
Average Hospital Charge
$555.84
Markup Ratio
3.7x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$555.84
Medicare Allowed$148.96
Medicare Payment$113.69

Hospitals charge 3.7x more than what Medicare allows for this procedure. Medicare actually pays $113.69 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$199$49194806+33.9%
Oklahoma$195$6203183+31.2%
New Mexico$194$794474+30.3%
Nebraska$187$5995236+25.5%
Iowa$183$548171,592+23.0%
Maryland$164$5082159+10.4%
Pennsylvania$163$46433255+9.3%
Ohio$146$4872045-2.2%
New York$142$89552211-4.6%
Colorado$142$4932261-4.6%
Minnesota$138$6921021-7.1%
New Jersey$128$75138120-13.9%
Illinois$128$68232299-14.3%
Michigan$126$67840237-15.6%
Nevada$126$566616-15.6%
Connecticut$125$751528-15.8%
Idaho$125$596313-15.8%
South Dakota$125$270213-16.3%
New Hampshire$125$470311-16.4%
Massachusetts$123$7621654-17.4%
Maine$123$863118-17.7%
North Carolina$122$5603890-18.1%
Florida$121$478111681-18.6%
Missouri$119$3621041-20.2%
Georgia$119$6022456-20.3%
Virginia$117$5042777-21.3%
Hawaii$116$686235-22.4%
Texas$112$551127516-24.6%
Washington$112$6611142-24.6%
Kansas$112$461751-24.9%
Delaware$112$503538-25.1%
Arizona$111$48323271-25.5%
Wisconsin$110$1,1061028-26.4%
Utah$109$4821123-27.1%
Tennessee$109$62233155-27.2%
South Carolina$103$5191282-30.8%
Kentucky$101$38410130-32.4%
Indiana$100$4521240-32.7%
Louisiana$100$49930151-33.1%
Alabama$99$30024100-33.7%
Arkansas$98$400116-34.2%
Mississippi$98$5671279-34.4%
Vermont$69$156512-54.0%

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

Related from TheDataProject.ai

💊 Need post-procedure medications? Check costs on OpenPrescriber