31231

Diagnostic exam of nasal passages using an endoscope

Medicare pricing data for 11,917 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $62 in Vermont to $220 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

Diagnostic exam of nasal passages using an endoscope (HCPCS code 31231) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $176.00, but hospitals typically charge $529.52 — a 3.0x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$35.20

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $176.00, your out-of-pocket cost would be approximately $35.20. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$176.00
Average Hospital Charge
$529.52
Markup Ratio
3.0x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$529.52
Medicare Allowed$176.00
Medicare Payment$133.20

Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $133.20 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$220$437392,418+25.0%
New York$220$75685894,903+25.0%
New Jersey$215$66235136,563+22.0%
Maryland$202$48222417,376+14.8%
Connecticut$201$6461397,817+14.3%
Rhode Island$192$48120892+9.0%
Hawaii$191$398392,339+8.3%
Alaska$189$92535439+7.2%
Puerto Rico$186$247431,151+5.8%
Florida$183$42887092,639+3.9%
Wyoming$181$40715553+3.1%
Massachusetts$178$67034522,634+1.2%
Colorado$178$4912339,027+1.1%
Texas$176$49885335,324+0.3%
Arizona$176$49619015,042+0.2%
Illinois$175$56546623,288-0.6%
Virginia$174$42829012,947-0.9%
Georgia$174$57638817,103-1.0%
Washington$174$4822537,904-1.3%
Pennsylvania$172$42261637,323-2.3%
Nevada$171$475562,762-2.9%
Delaware$171$448363,153-3.1%
Indiana$170$4342127,398-3.2%
Minnesota$170$6522365,058-3.3%
Oklahoma$168$4791253,790-4.8%
Missouri$167$5312255,858-5.0%
Montana$166$409541,916-5.7%
Kentucky$166$3291705,851-5.9%
Kansas$165$3911155,568-6.3%
North Carolina$165$46737114,177-6.5%
South Carolina$163$45124914,016-7.3%
Oregon$163$5571564,738-7.6%
Maine$162$353531,314-7.8%
Arkansas$162$433732,082-8.0%
South Dakota$161$495481,097-8.6%
Louisiana$158$5272306,112-10.2%
Mississippi$157$488843,249-11.0%
Michigan$155$3863838,478-11.9%
Tennessee$155$5152358,545-12.1%
Alabama$151$3351646,330-14.2%
Idaho$147$449601,496-16.6%
Utah$146$4311122,341-17.2%
Nebraska$145$4491133,908-17.4%
Iowa$145$5401364,791-17.9%
West Virginia$143$462661,304-18.6%
Ohio$140$43841311,984-20.7%
Wisconsin$138$9342364,616-21.8%
California$137$4831,039104,980-22.2%
New Mexico$128$407611,717-27.4%
New Hampshire$119$400611,348-32.2%
North Dakota$85$29042537-51.9%
Vermont$62$11213383-65.0%

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

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💊 Need post-procedure medications? Check costs on OpenPrescriber