Price Checker / CPT 31257

How much does Nsl/sins Ndsc Tot W/sphendt cost?

CPT 31257 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 65x the fair price — among the most extreme markups. Dispute this.

Fair price

$560–$1,150

What this should cost

With insurance

~$4,200

Typical out-of-pocket

Overcharged if over

$1,450

Push back above this

The average hospital charge of $56,265 is $55,405 over the fair price (about 65x the fair rate).

What hospitals charge for Nsl/sins Ndsc Tot W/sphendt

From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.

HospitalGross ChargeCash Ratevs Medicare
ST RITA'S MEDICAL CENTER

Lima, OH

$114,00819984%
Northern Light Maine Coast Hospital

Ellsworth, ME

$56,86613125%
KINGS MILLS HOSPITAL

Mason, OH

$45,4058581%
Animas Surgical Hospital

, CO

$8,7822839%

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About Nsl/sins Ndsc Tot W/sphendt

CPT code 31257 refers to nsl/sins ndsc tot w/sphendt (billing description: "Nsl/sins ndsc tot w/sphendt"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $375 in a facility (hospital or surgery center) and $375 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

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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