92511

Exam of the nose and throat using an endoscope

Medicare pricing data for 3,913 providers across 51 states

🤖AI Overview

Prices vary significantly by location — from $33 in Vermont to $139 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

Exam of the nose and throat using an endoscope (HCPCS code 92511) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $109.81, but hospitals typically charge $337.26 — a 3.1x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$21.96

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $109.81, your out-of-pocket cost would be approximately $21.96. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$109.81
Average Hospital Charge
$337.26
Markup Ratio
3.1x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$337.26
Medicare Allowed$109.81
Medicare Payment$82.71

Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $82.71 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
District of Columbia$139$3681292+26.2%
Alaska$134$4831761+22.1%
New Jersey$130$3851051,527+18.0%
New York$129$4112863,857+17.5%
California$126$3492973,297+14.5%
Rhode Island$123$2601172+11.8%
Hawaii$122$257863+11.2%
Maryland$120$35171471+9.5%
Connecticut$120$42659492+8.9%
Nevada$117$3571080+6.5%
Puerto Rico$115$122733+5.0%
Montana$114$3591329+3.8%
Massachusetts$113$4791771,605+3.1%
Georgia$113$3651251,621+2.8%
Colorado$111$28448374+1.4%
Idaho$110$32214124-0.2%
Arizona$109$244913,180-0.9%
Florida$109$3082753,517-1.0%
Illinois$108$3131531,390-1.6%
North Carolina$108$3631281,124-1.7%
New Hampshire$106$37723165-3.7%
Virginia$104$28091393-5.4%
Oregon$104$36450216-5.5%
Oklahoma$104$28140234-5.7%
Texas$103$3892423,119-5.8%
Washington$103$29783470-6.5%
Mississippi$102$2862185-7.4%
Nebraska$101$2951772-7.7%
South Carolina$101$29085509-7.8%
Kansas$101$34934218-8.0%
Minnesota$100$42792284-9.0%
Michigan$100$251108806-9.2%
Indiana$100$26185348-9.2%
Pennsylvania$98$238117816-11.2%
Kentucky$97$23760310-11.5%
Missouri$92$26191664-16.6%
Ohio$90$283181893-17.7%
Alabama$90$24457358-17.8%
Arkansas$90$28823116-18.4%
Louisiana$88$24470408-19.4%
Iowa$88$34571564-20.3%
New Mexico$87$28513276-21.0%
Delaware$87$215833-21.0%
Utah$87$31138164-21.1%
Tennessee$83$34280294-24.1%
Wisconsin$79$48189287-28.2%
West Virginia$74$2391936-33.0%
North Dakota$71$4521361-35.5%
South Dakota$61$2021960-44.2%
Maine$43$1451956-61.1%
Vermont$33$1471669-69.9%

⚠️ 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