Biopsy or removal of nasal polyp or tissue using an endoscope
Medicare pricing data for 7,691 providers across 52 states
Prices vary significantly by location — from $153 in Vermont to $375 in New York. 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
Biopsy or removal of nasal polyp or tissue using an endoscope (HCPCS code 31237) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $319.91, but hospitals typically charge $1,279 — a 4.0x 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 $319.91, your out-of-pocket cost would be approximately $63.98. 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 4.0x more than what Medicare allows for this procedure. Medicare actually pays $250.38 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $375 | $2,331 | 413 | 4,576 | +17.2% |
| New Jersey | $371 | $2,058 | 203 | 2,287 | +16.1% |
| District of Columbia | $359 | $1,232 | 20 | 230 | +12.2% |
| Maryland | $350 | $1,223 | 143 | 1,617 | +9.5% |
| Connecticut | $346 | $1,664 | 96 | 642 | +8.2% |
| California | $345 | $1,288 | 671 | 8,409 | +7.8% |
| Alaska | $342 | $2,866 | 26 | 104 | +6.8% |
| Illinois | $340 | $1,740 | 264 | 3,293 | +6.2% |
| Texas | $333 | $1,166 | 594 | 7,854 | +4.1% |
| Florida | $332 | $966 | 573 | 8,105 | +3.8% |
| Arizona | $328 | $1,284 | 160 | 2,859 | +2.4% |
| Nevada | $321 | $911 | 44 | 663 | +0.4% |
| Colorado | $320 | $951 | 155 | 1,188 | -0.1% |
| Georgia | $319 | $1,492 | 285 | 2,460 | -0.3% |
| Minnesota | $317 | $1,520 | 115 | 957 | -0.9% |
| Virginia | $316 | $1,214 | 206 | 1,494 | -1.1% |
| Rhode Island | $316 | $1,201 | 17 | 87 | -1.3% |
| Washington | $314 | $975 | 174 | 1,907 | -1.8% |
| South Dakota | $308 | $879 | 38 | 226 | -3.8% |
| Missouri | $307 | $1,282 | 161 | 1,333 | -3.9% |
| Wyoming | $307 | $1,308 | 11 | 98 | -4.2% |
| Kentucky | $306 | $912 | 117 | 923 | -4.4% |
| Kansas | $305 | $906 | 94 | 1,776 | -4.6% |
| Indiana | $305 | $1,222 | 159 | 1,371 | -4.7% |
| Puerto Rico | $305 | $420 | 15 | 72 | -4.7% |
| Louisiana | $301 | $1,271 | 154 | 1,664 | -6.0% |
| Hawaii | $300 | $573 | 22 | 154 | -6.3% |
| Utah | $299 | $989 | 93 | 599 | -6.5% |
| Massachusetts | $298 | $1,513 | 178 | 1,763 | -6.8% |
| Oklahoma | $297 | $1,067 | 91 | 771 | -7.2% |
| Wisconsin | $296 | $1,920 | 126 | 1,319 | -7.4% |
| Mississippi | $296 | $1,362 | 71 | 970 | -7.6% |
| Delaware | $295 | $1,047 | 22 | 329 | -7.7% |
| North Carolina | $292 | $1,246 | 246 | 2,305 | -8.7% |
| Montana | $292 | $863 | 40 | 376 | -8.9% |
| Pennsylvania | $291 | $1,053 | 363 | 3,474 | -9.0% |
| Michigan | $289 | $829 | 220 | 1,200 | -9.7% |
| Maine | $288 | $826 | 24 | 199 | -9.9% |
| South Carolina | $286 | $1,170 | 166 | 1,849 | -10.5% |
| Iowa | $286 | $1,219 | 84 | 606 | -10.7% |
| Oregon | $285 | $985 | 107 | 777 | -11.0% |
| Tennessee | $284 | $1,219 | 170 | 1,818 | -11.2% |
| Ohio | $283 | $1,025 | 278 | 2,055 | -11.6% |
| Alabama | $281 | $890 | 134 | 1,769 | -12.3% |
| Idaho | $272 | $941 | 51 | 342 | -14.9% |
| Nebraska | $258 | $996 | 93 | 721 | -19.2% |
| Arkansas | $252 | $737 | 55 | 291 | -21.2% |
| West Virginia | $248 | $902 | 37 | 137 | -22.5% |
| New Mexico | $240 | $875 | 35 | 167 | -24.9% |
| New Hampshire | $239 | $1,324 | 36 | 145 | -25.4% |
| North Dakota | $168 | $511 | 24 | 88 | -47.6% |
| Vermont | $153 | $371 | 6 | 39 | -52.2% |
⚠️ 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