31238

Control of bleeding of nose using an endoscope

Medicare pricing data for 4,922 providers across 52 states

🤖AI Overview

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

Control of bleeding of nose using an endoscope (HCPCS code 31238) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $253.59, but hospitals typically charge $954.24 — a 3.8x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$50.72

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $253.59, your out-of-pocket cost would be approximately $50.72. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$253.59
Average Hospital Charge
$954.24
Markup Ratio
3.8x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$954.24
Medicare Allowed$253.59
Medicare Payment$195.04

Hospitals charge 3.8x more than what Medicare allows for this procedure. Medicare actually pays $195.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New York$306$1,3602882,039+20.8%
Alaska$296$3,8951116+16.6%
District of Columbia$292$691720+15.2%
New Jersey$281$1,216152806+11.0%
California$276$1,0493611,633+9.0%
Maryland$274$96398650+8.1%
Rhode Island$270$727736+6.4%
Hawaii$269$733727+6.1%
Wyoming$267$1,5681828+5.3%
Delaware$263$613615+3.9%
Washington$263$955122508+3.7%
Connecticut$262$1,23652170+3.4%
Massachusetts$260$1,003128507+2.6%
Florida$260$7214112,613+2.6%
Colorado$260$1,03189379+2.5%
Puerto Rico$258$3111221+1.8%
Nevada$253$98914100-0.2%
Illinois$249$1,0381901,022-1.8%
Virginia$247$787133459-2.6%
Pennsylvania$247$8232751,588-2.6%
Texas$245$9133631,403-3.5%
Montana$242$665938-4.7%
Minnesota$241$1,21862140-5.1%
Indiana$240$1,207104307-5.2%
South Carolina$239$786120537-5.6%
Alabama$239$99891309-5.9%
Michigan$238$738105268-6.1%
New Mexico$238$1,4262351-6.2%
Kentucky$237$58368198-6.7%
South Dakota$236$8101029-6.8%
Georgia$236$1,018192669-7.0%
Arizona$235$625103531-7.3%
North Carolina$233$902150606-8.3%
Tennessee$231$897111339-8.9%
Idaho$231$8172392-9.1%
Iowa$230$99169248-9.2%
Louisiana$229$1,042108386-9.5%
Kansas$227$84784426-10.3%
Missouri$227$84897319-10.4%
Oregon$223$79363177-12.0%
Mississippi$219$95746166-13.5%
Nebraska$217$63342174-14.4%
Maine$216$7301634-14.7%
Ohio$216$701167612-14.9%
Utah$215$9623799-15.2%
Arkansas$214$63546149-15.5%
Oklahoma$208$65055147-18.0%
Wisconsin$206$1,98077166-18.8%
West Virginia$201$7622381-20.6%
New Hampshire$192$1,0912454-24.3%
North Dakota$162$1,293615-36.3%
Vermont$160$640516-36.9%

⚠️ 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