Price Checker / CPT 31256
How much does Exploration Maxillary Sinus cost?
CPT 31256 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 72x the fair price — among the most extreme markups. Dispute this.
Fair price
$230–$460
What this should cost
With insurance
~$3,200
Typical out-of-pocket
Overcharged if over
$580
Push back above this
The average hospital charge of $25,096 is $24,746 over the fair price (about 72x the fair rate).
What hospitals charge for Exploration Maxillary Sinus
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| ST RITA'S MEDICAL CENTER Lima, OH | $103,454 | — | 42737% |
| Valley View Medical Center FORT MOHAVE, AZ | $58,548 | — | 38257% |
| AdventHealth Lenexa City Center , KS | $47,676 | $23,838 | 31134% |
| AdventHealth Overland Park , KS | $47,676 | $23,838 | 31134% |
| AdventHealth Shawnee Mission SHAWNEE MISSION, KS | $47,676 | $23,838 | 31134% |
| The Christ Hospital Inpatient Psychiatry , OH | $36,175 | $19,160 | 23600% |
| The Christ Hospital Inpatient Rehab , OH | $36,175 | $19,160 | 23600% |
| The Christ Hospital Liberty , OH | $36,175 | $19,160 | 23600% |
| The Christ Hospital , OH | $36,175 | $19,160 | 23600% |
| Centrastate Medical Center FREEHOLD, NJ | $35,808 | $9,002 | 23359% |
| "Cohen Children's Medical Center" , NY | — | $4,595 | 16861% |
| Glen Cove Hospital , NY | — | $4,595 | 16861% |
| Huntington Hospital PASADENA, NY | — | $4,595 | 16861% |
| Lenox Hill Hospital NEW YORK, NY | — | $4,595 | 16861% |
| Long Island Jewish Forest Hills , NY | — | $4,595 | 16861% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Exploration Maxillary Sinus
CPT code 31256 refers to exploration maxillary sinus (billing description: "Exploration maxillary sinus"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $153 in a facility (hospital or surgery center) and $153 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.