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Sinus Surgery to Open the Cheek Sinus

Washington, DC rates for HCPCS 31256

Using a thin telescope passed up the nostril, the surgeon enlarges the natural drainage opening of the maxillary sinus, the air pocket behind the cheek, so mucus can escape and the sinus can ventilate properly. No cuts are made on the face. It is used for repeated or long-standing sinus infection that has not settled with medication.

Rates data updated October 2026.

How much does Sinus Surgery to Open the Cheek Sinus cost?

$263

Typical physician fee. In Washington, DC, October 2026.

Insurers have agreed to pay about $263 for this service. Most negotiated rates run $186 to $525.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $3,388 · 10th to 90th $437 to $19,953Professionalmedian $214 · 10th to 90th $166 to $2,399
$200$500$1K$2K$5K$10K$20Kfacility $3,388professional $214

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$213.80
Median
$2,137.96
Typical High
$6,606.93
Aetna
Setting
Professional
Modifier
None
Typical Low
$204.17
Median
$213.80
Typical High
$512.86
CareFirst
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$186.21
Typical High
$4,570.88
Cigna
Setting
Professional
Modifier
None
Typical Low
$186.21
Median
$239.88
Typical High
$478.63
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$158.49
Median
$165.96
Typical High
$407.38
United
Setting
Facility
Modifier
None
Typical Low
$1,288.25
Median
$5,754.40
Typical High
$27,542.29
United
Setting
Professional
Modifier
None
Typical Low
$165.96
Median
$257.04
Typical High
$501.19

Where Washington, DC sits

The same service costs 6.9 times more in Kansas than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 35th of 51

$263

KS $1,259NY $182

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.