Incision, aspiration, and/or inflation of eardrum
Medicare pricing data for 3,174 providers across 50 states
Prices vary significantly by location — from $123 in New Mexico to $247 in Alaska. 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
Incision, aspiration, and/or inflation of eardrum (HCPCS code 69420) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $200.69, but hospitals typically charge $536.90 — a 2.7x 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 $200.69, your out-of-pocket cost would be approximately $40.14. 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 2.7x more than what Medicare allows for this procedure. Medicare actually pays $152.40 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $247 | $995 | 9 | 20 | +23.1% |
| New Jersey | $233 | $788 | 109 | 489 | +16.2% |
| New York | $230 | $886 | 205 | 680 | +14.4% |
| California | $226 | $608 | 283 | 1,112 | +12.8% |
| District of Columbia | $220 | $526 | 8 | 29 | +9.7% |
| Maryland | $218 | $508 | 75 | 366 | +8.6% |
| Connecticut | $216 | $529 | 50 | 204 | +7.4% |
| Massachusetts | $215 | $695 | 79 | 305 | +7.1% |
| Montana | $211 | $690 | 13 | 35 | +5.4% |
| Washington | $206 | $553 | 69 | 223 | +2.4% |
| Hawaii | $205 | $412 | 7 | 15 | +2.3% |
| Florida | $205 | $468 | 203 | 1,190 | +2.3% |
| Illinois | $204 | $635 | 94 | 402 | +1.4% |
| Rhode Island | $203 | $449 | 7 | 28 | +1.2% |
| New Hampshire | $202 | $714 | 18 | 60 | +0.7% |
| Oregon | $201 | $594 | 39 | 98 | +0.0% |
| Pennsylvania | $200 | $434 | 143 | 697 | -0.5% |
| Texas | $200 | $476 | 251 | 1,081 | -0.6% |
| Minnesota | $200 | $735 | 62 | 198 | -0.6% |
| Virginia | $199 | $476 | 108 | 422 | -0.7% |
| Colorado | $197 | $567 | 59 | 176 | -1.9% |
| Delaware | $196 | $489 | 11 | 51 | -2.4% |
| Nevada | $194 | $436 | 16 | 40 | -3.5% |
| Georgia | $190 | $554 | 116 | 358 | -5.4% |
| South Carolina | $190 | $333 | 86 | 425 | -5.4% |
| Missouri | $189 | $479 | 68 | 276 | -6.0% |
| Louisiana | $189 | $447 | 52 | 248 | -6.0% |
| Nebraska | $187 | $509 | 31 | 112 | -7.0% |
| Kentucky | $186 | $397 | 32 | 122 | -7.2% |
| North Carolina | $185 | $469 | 111 | 382 | -7.6% |
| Maine | $185 | $372 | 10 | 42 | -7.8% |
| Wisconsin | $185 | $1,088 | 42 | 120 | -7.8% |
| Idaho | $185 | $472 | 15 | 35 | -7.9% |
| Arizona | $184 | $386 | 60 | 274 | -8.2% |
| Michigan | $184 | $463 | 80 | 252 | -8.4% |
| Wyoming | $184 | $611 | 3 | 11 | -8.5% |
| Tennessee | $183 | $574 | 77 | 375 | -9.0% |
| Utah | $182 | $431 | 33 | 94 | -9.4% |
| Alabama | $181 | $316 | 64 | 215 | -9.8% |
| Iowa | $181 | $482 | 34 | 99 | -10.0% |
| Oklahoma | $181 | $536 | 18 | 49 | -10.0% |
| Indiana | $180 | $511 | 68 | 191 | -10.1% |
| Ohio | $177 | $449 | 111 | 460 | -11.7% |
| South Dakota | $177 | $565 | 14 | 44 | -11.9% |
| Kansas | $175 | $405 | 36 | 126 | -12.6% |
| Mississippi | $173 | $407 | 28 | 164 | -13.8% |
| Arkansas | $172 | $366 | 25 | 158 | -14.1% |
| West Virginia | $169 | $468 | 20 | 69 | -15.8% |
| North Dakota | $155 | $434 | 9 | 29 | -22.5% |
| New Mexico | $123 | $570 | 5 | 12 | -38.6% |
⚠️ 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