Dilation of sphenoid and frontal nasal sinus using an endoscope
Medicare pricing data for 852 providers across 38 states
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
Dilation of sphenoid and frontal nasal sinus using an endoscope (HCPCS code 31298) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $4,619, but hospitals typically charge $14,803 — a 3.2x 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 $4,619, your out-of-pocket cost would be approximately $923.87. 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 3.2x more than what Medicare allows for this procedure. Medicare actually pays $3,679 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $5,677 | $12,591 | 2 | 41 | +22.9% |
| New York | $5,411 | $20,481 | 53 | 284 | +17.1% |
| Maine | $5,349 | $9,844 | 1 | 22 | +15.8% |
| Hawaii | $5,244 | $8,708 | 2 | 29 | +13.5% |
| Connecticut | $5,209 | $21,560 | 13 | 140 | +12.8% |
| California | $5,147 | $11,891 | 87 | 1,458 | +11.4% |
| New Jersey | $4,895 | $12,405 | 9 | 43 | +6.0% |
| Massachusetts | $4,807 | $25,153 | 9 | 14 | +4.1% |
| Maryland | $4,632 | $13,963 | 17 | 140 | +0.3% |
| Nevada | $4,614 | $14,604 | 13 | 447 | -0.1% |
| Oregon | $4,583 | $16,001 | 4 | 29 | -0.8% |
| Texas | $4,580 | $17,950 | 139 | 1,383 | -0.9% |
| Pennsylvania | $4,577 | $15,828 | 13 | 92 | -0.9% |
| Virginia | $4,562 | $17,613 | 24 | 192 | -1.2% |
| Florida | $4,529 | $14,870 | 109 | 746 | -1.9% |
| Michigan | $4,529 | $11,392 | 24 | 90 | -2.0% |
| Oklahoma | $4,518 | $11,497 | 4 | 158 | -2.2% |
| Missouri | $4,508 | $12,400 | 11 | 237 | -2.4% |
| Georgia | $4,418 | $17,052 | 44 | 173 | -4.4% |
| Arizona | $4,410 | $12,434 | 31 | 973 | -4.5% |
| Minnesota | $4,383 | $20,163 | 8 | 14 | -5.1% |
| Illinois | $4,274 | $14,734 | 28 | 179 | -7.5% |
| Indiana | $4,269 | $13,532 | 15 | 208 | -7.6% |
| Ohio | $4,241 | $11,961 | 11 | 136 | -8.2% |
| Idaho | $4,198 | $14,859 | 3 | 14 | -9.1% |
| Utah | $4,182 | $14,551 | 8 | 25 | -9.5% |
| Alabama | $4,178 | $11,310 | 16 | 163 | -9.5% |
| West Virginia | $4,158 | $18,068 | 1 | 12 | -10.0% |
| Iowa | $4,154 | $23,013 | 8 | 18 | -10.1% |
| Colorado | $4,133 | $12,305 | 11 | 38 | -10.5% |
| Louisiana | $4,089 | $14,090 | 16 | 200 | -11.5% |
| Wisconsin | $4,083 | $20,881 | 10 | 63 | -11.6% |
| Tennessee | $4,074 | $17,378 | 23 | 97 | -11.8% |
| South Carolina | $4,047 | $11,921 | 12 | 122 | -12.4% |
| North Carolina | $4,041 | $16,522 | 25 | 94 | -12.5% |
| Washington | $3,954 | $12,510 | 4 | 28 | -14.4% |
| Mississippi | $3,935 | $33,734 | 14 | 78 | -14.8% |
| Kentucky | $3,844 | $10,352 | 14 | 30 | -16.8% |
⚠️ 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