Complex GI Procedures in Utah
What 17 hospitals in Utah charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$18,038
Hospital list price billed
Average allowed
$4,182
Medicare's payment + patient's share
Medicare paid
$3,328
Average per service
State rank
#3 of 48
1 = lowest average payment
Hospitals in Utah billed an average of $18,038 for complex gi procedures, about 4.3 times the average medicare-allowed amount of $4,182. That payment is 22% below the U.S. average of $5,364.
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.
Paid $4,182Billed $18,038
About 23¢ was paid for every $1 hospitals in Utah billed for this service.
Utah hospitals: complex gi procedures
Every Utah hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University Health Care/Univ Hospitals and ClinicsSalt Lake City | 141 | $17,121 | $3,845 | $3,058 |
| McKay-Dee Hospital CenterOgden | 22 | $16,965 | $5,105 | $4,068 |
| Lds HospitalSalt Lake City | 20 | $23,087 | $5,105 | $4,068 |
| Utah Valley Regional Medical CenterProvo | 15 | $21,502 | $4,765 | $3,797 |
| Cottonwood Hospital Med CntrMurray | – | – | – | – |
| Intermountain Health Cedar City HospitalCedar City | – | – | – | – |
| Castleview HospitalPrice | – | – | – | – |
| Logan Regional HospitalLogan | – | – | – | – |
| St. George Regional HospitalSt George | – | – | – | – |
| American Fork HospitalAmerican Fork | – | – | – | – |
| Ashley Valley Medical CenterVernal | – | – | – | – |
| Lakeview HospitalBountiful | – | – | – | – |
| Alta View HospitalSandy | – | – | – | – |
| St Marks HospitalSalt Lake City | – | – | – | – |
| Jordan Valley Medical CenterWest Jordan | – | – | – | – |
| Riverton HospitalRiverton | – | – | – | – |
| Intermountain Health Layton HospitalLayton | – | – | – | – |
Lowest and highest allowed amounts in Utah
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| University Health Care/Univ Hospitals and ClinicsSalt Lake City, UT | $3,845 |
|---|---|
| Utah Valley Regional Medical CenterProvo, UT | $4,765 |
| McKay-Dee Hospital CenterOgden, UT | $5,105 |
| Lds HospitalSalt Lake City, UT | $5,105 |
Highest
| McKay-Dee Hospital CenterOgden, UT | $5,105 |
|---|---|
| Lds HospitalSalt Lake City, UT | $5,105 |
| Utah Valley Regional Medical CenterProvo, UT | $4,765 |
| University Health Care/Univ Hospitals and ClinicsSalt Lake City, UT | $3,845 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Utah?
In 2024 Medicare data, complex gi procedures (APC 5331) at 17 hospitals in Utah was billed at $18,038 on average, while the average medicare-allowed amount was $4,182, of which Medicare paid $3,328. 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 service in Utah, average charges were 4.3 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.