Comprehensive Observation Services
What 2,914 hospitals in the U.S. charged and were paid for comprehensive observation services (APC 8011), from 2024 Medicare claims.
Average charge
$24,060
Hospital list price billed
Average allowed
$2,634
Medicare's payment + patient's share
Medicare paid
$2,090
Average per service
Volume
815,315
Medicare services
Hospitals in the U.S. billed an average of $24,060 for comprehensive observation services, about 9.1 times the average medicare-allowed amount of $2,634.
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.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Central Vermont Medical CenterGraniteville-East Barre, VT | $1,132 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $1,180 |
| Rutland Regional Medical CenterRutland, VT | $1,375 |
| Marietta Memorial HospitalMarietta, OH | $1,451 |
| Metrohealth SystemCleveland, OH | $1,481 |
| Southwestern Vermont Medical CenterBennington, VT | $1,485 |
| Brattleboro Memorial HospitalBrattleboro, VT | $1,580 |
| Memorial HospitalFremont, OH | $1,958 |
| Shelby Baptist Medical CenterAlabaster, AL | $1,973 |
| Coosa Valley Medical CenterSylacauga, AL | $2,053 |
Highest
| Northbay Medical CenterFairfield, CA | $3,929 |
|---|---|
| Seton Medical CenterDaly City, CA | $3,913 |
| Chinese HospitalSan Francisco, CA | $3,913 |
| California Pacific Medical Ctr - St. Luke's CampusSan Francisco, CA | $3,913 |
| St Mary's Medical CenterSan Francisco, CA | $3,913 |
| California Pacific Medical Ctr-Pacific Campus HospSan Francisco, CA | $3,913 |
| Sutter Solano Medical CenterVallejo, CA | $3,895 |
| San Francisco General HospitalSan Francisco, CA | $3,886 |
| California Pacific Medical Ctr-Davies Campus HospSan Francisco, CA | $3,876 |
| Peninsula Medical CenterBurlingame, CA | $3,875 |
Comprehensive Observation Services cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 78 | $16,654 | $2,241 | $1,338 – $2,461 |
| Alaska | 6 | $28,781 | $2,936 | $2,792 – $3,008 |
| Arizona | 56 | $24,113 | $2,686 | $2,402 – $2,963 |
| Arkansas | 45 | $15,203 | $2,356 | $2,251 – $2,503 |
| California | 262 | $41,651 | $3,471 | $2,709 – $3,929 |
| Colorado | 51 | $34,078 | $2,608 | $2,542 – $2,791 |
| Connecticut | 27 | $23,464 | $3,045 | $2,983 – $3,270 |
| Delaware | 7 | $16,076 | $2,718 | $2,693 – $2,742 |
| Florida | 172 | $28,435 | $2,457 | $2,240 – $2,656 |
| Georgia | 96 | $20,908 | $2,422 | $2,240 – $2,629 |
| Hawaii | 13 | $18,387 | $3,127 | $2,812 – $3,324 |
| Idaho | 14 | $16,167 | $2,548 | $2,407 – $2,649 |
| Illinois | 116 | $21,499 | $2,573 | $2,384 – $2,709 |
| Indiana | 76 | $18,400 | $2,464 | $2,345 – $2,632 |
| Iowa | 31 | $17,461 | $2,385 | $2,266 – $2,585 |
| Kansas | 39 | $22,608 | $2,377 | $2,230 – $2,657 |
| Kentucky | 62 | $20,339 | $2,359 | $2,195 – $2,523 |
| Louisiana | 70 | $16,203 | $2,288 | $2,225 – $2,437 |
| Maine | 17 | $13,250 | $2,457 | $2,332 – $2,644 |
| Massachusetts | 55 | $14,010 | $2,920 | $2,858 – $3,148 |
| Michigan | 85 | $15,357 | $2,410 | $2,218 – $2,618 |
| Minnesota | 47 | $14,739 | $2,627 | $1,835 – $2,806 |
| Mississippi | 54 | $16,071 | $2,278 | $2,143 – $2,442 |
| Missouri | 65 | $20,563 | $2,393 | $2,164 – $2,612 |
| Montana | 10 | $10,951 | $2,595 | $2,488 – $2,749 |
| Nebraska | 22 | $16,382 | $2,450 | $2,334 – $2,615 |
| Nevada | 21 | $39,164 | $2,900 | $2,834 – $3,323 |
| New Hampshire | 13 | $20,649 | $2,637 | $2,559 – $2,796 |
| New Jersey | 61 | $34,393 | $2,897 | $2,684 – $3,115 |
| New Mexico | 22 | $21,444 | $2,469 | $2,252 – $2,766 |
| New York | 120 | $26,682 | $2,983 | $2,593 – $3,156 |
| North Carolina | 79 | $18,779 | $2,426 | $2,319 – $2,712 |
| North Dakota | 6 | $13,866 | $2,590 | $2,519 – $2,697 |
| Ohio | 116 | $17,047 | $2,317 | $1,451 – $2,591 |
| Oklahoma | 66 | $18,852 | $2,348 | $2,223 – $2,500 |
| Oregon | 32 | $16,975 | $2,901 | $2,654 – $3,559 |
| Pennsylvania | 127 | $21,723 | $2,553 | $2,299 – $2,859 |
| Rhode Island | 10 | $17,100 | $2,752 | $2,745 – $2,778 |
| South Carolina | 51 | $20,766 | $2,368 | $2,124 – $2,562 |
| South Dakota | 11 | $18,366 | $2,638 | $2,501 – $2,748 |
| Tennessee | 78 | $19,934 | $2,299 | $2,091 – $2,505 |
| Texas | 266 | $27,955 | $2,445 | $2,235 – $2,718 |
| Utah | 32 | $18,171 | $2,478 | $2,330 – $2,626 |
| Vermont | 6 | $16,441 | $1,285 | $1,132 – $1,580 |
| Virginia | 70 | $19,506 | $2,459 | $2,283 – $2,661 |
| Washington | 46 | $22,407 | $2,802 | $2,625 – $3,020 |
| West Virginia | 23 | $15,704 | $2,285 | $2,132 – $2,550 |
| Wisconsin | 65 | $17,715 | $2,497 | $2,329 – $2,673 |
| Wyoming | 10 | $15,000 | $2,722 | $2,639 – $2,748 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 3,106 | $37,344 | $2,427 |
| NYU Hospitals CenterNew York, NY | 2,823 | $43,280 | $3,061 |
| Yale-New Haven HospitalNew Haven, CT | 2,601 | $29,760 | $3,054 |
| Southcoast Hospital Group, INCFall River, MA | 2,598 | $12,395 | $2,917 |
| Massachusetts General HospitalBoston, MA | 2,507 | $19,776 | $2,927 |
| Boca Raton Regional HospitalBoca Raton, FL | 2,493 | $20,403 | $2,465 |
| Mem Hermann Southwest HospHouston, TX | 2,449 | $32,741 | $2,509 |
| St Joseph's HospitalTampa, FL | 2,431 | $24,566 | $2,457 |
| Yuma Regional Medical CenterYuma, AZ | 2,412 | $26,832 | $2,855 |
| Martin Memorial Health SystemsStuart, FL | 2,405 | $22,287 | $2,461 |
| Northeast Georgia Medical Center, INCGainesville, GA | 2,366 | $24,165 | $2,453 |
| Jefferson Stratford HospitalCherry Hill, NJ | 2,235 | $17,545 | $2,834 |
| Stanford HospitalPalo Alto, CA | 2,217 | $76,792 | $3,839 |
| Baptist Hospital EastLouisville, KY | 2,158 | $25,609 | $2,323 |
| South Shore HospitalSouth Weymouth, MA | 2,114 | $9,731 | $2,913 |
Questions
How much does comprehensive observation services cost in the U.S.?
In 2024 Medicare data, comprehensive observation services (APC 8011) at 2,914 hospitals in the U.S. was billed at $24,060 on average, while the average medicare-allowed amount was $2,634, of which Medicare paid $2,090. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for comprehensive observation services?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($3,471), Hawaii ($3,127), Connecticut ($3,045) and lowest in Vermont ($1,285), Alabama ($2,241), Mississippi ($2,278).
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 the U.S., average charges were 9.1 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.