Billed is the hospital's list price. Average payment is what Medicare, the patient and any other insurer paid in total. Medicare paid is Medicare's part. A Medicare category can group several related procedures, and these are averages, not a quote.
According to HospitalsInEachState.com's analysis of 2024 Medicare inpatient claims data from CMS, the average total payment for a hospital stay for breast biopsy, local excision and other breast procedures without complications (DRG 585) in Louisiana was $12,759 (what Medicare and the patient, plus any other insurer, paid), of which Medicare paid $8,521, across 1 hospital. Hospitals billed $156,438 on average, their list charge. The payments are averages for original Medicare patients, not a price quote.
Hospitals in Louisiana billed an average of $156,438 for breast biopsy, local excision and other breast procedures without complications, about 12.3 times the average total payment of $12,759. That payment is 31% below the U.S. average of $18,578.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
About 8¢ was paid for every $1 hospitals in Louisiana billed for this stay.
Louisiana hospitals: breast biopsy, local excision and other breast procedures without complications
Every Louisiana hospital that billed Medicare for this stay at least 11 times. Use the column headings to sort.
| St Charles Surgical HospitalNew Orleans | 24 | $156,438 | $12,759 | $8,521 |
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Breast biopsy, local excision and other breast procedures without complications in other states
Questions
How much does breast biopsy, local excision and other breast procedures without complications cost in Louisiana?
In 2024 Medicare data, a hospital stay for breast biopsy, local excision and other breast procedures without complications (DRG 585) at 1 hospital in Louisiana was billed at $156,438 on average, while the average total payment was $12,759, of which Medicare paid $8,521. Your own cost depends on your insurance, deductible and the hospital.
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in Louisiana, average charges were 12.3 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.
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