facebook tracking Level 1 Breast/Lymphatic Surgery and Related Procedures cost in Kentucky: 50 hospitals compared (APC 5091)

Level 1 Breast/Lymphatic Surgery and Related Procedures in Kentucky

What 50 hospitals in Kentucky charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.

APC 5091 Outpatient 2024 Medicare data
Average charge $22,953 Hospital list price billed
Average allowed $3,266 Medicare's payment + patient's share
Medicare paid $2,590 Average per service
State rank #11 of 49 1 = lowest average payment

Hospitals in Kentucky billed an average of $22,953 for level 1 breast/lymphatic surgery and related procedures, about 7.0 times the average medicare-allowed amount of $3,266. That payment is 11% below the U.S. average of $3,688.

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 $3,266Billed $22,953

About 14¢ was paid for every $1 hospitals in Kentucky billed for this service.

Kentucky hospitals: level 1 breast/lymphatic surgery and related procedures

Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Norton Healthcare PavilionLouisville 119 $15,381 $3,251 $2,585
Baptist Hospital EastLouisville 111 $30,476 $3,273 $2,604
St Elizabeth Med Center-SouthEdgewood 64 $17,778 $3,078 $2,408
Hardin Memorial HospitalElizabethtown 48 $26,219 $3,284 $2,617
University of Louisville HospitalLouisville 47 $25,507 $3,223 $2,559
University of Kentucky HospLexington 44 $29,130 $3,140 $2,468
King's Daughters' Medical CenterAshland 39 $16,824 $3,247 $2,577
Central Baptist HospitalLexington 34 $30,241 $3,301 $2,629
Western Baptist HospitalPaducah 33 $28,161 $3,405 $2,691
Lourdes HospitalPaducah 25 $22,636 $3,488 $2,766
Owensboro Medical Health SystemOwensboro 22 $21,612 $3,527 $2,810
Saint Joseph EastLexington 20 $13,146 $3,301 $2,630
Baptist Regional Medical CtrCorbin 17 $20,011 $3,198 $2,548
The Medical Center at Bowling GreenBowling Green 16 $17,129 $3,293 $2,621
Pikeville Medical CenterPikeville 15 $24,599 $3,278 $2,574
Baptist Health Deaconess MadisonvilleMadisonville 12 $33,944 $3,527 $2,810
Ephraim McDowell Regional Medical CenterDanville 11 $12,763 $3,281 $2,614
St Elizabeth Ft ThomasFort Thomas – – – –
Whitesburg Arh HospitalWhitesburg – – – –
Highlands Regional Medical CenterPrestonsburg – – – –
Saint Joseph HospitalLexington – – – –
Saint Joseph LondonLondon – – – –
T J Samson Community HospitalGlasgow – – – –
St Claire Regional Medical CenterMorehead – – – –
Meadowview Regional Medical CenterMaysville – – – –
Middlesboro Appalachian Regional Healthcare HospitMiddlesboro – – – –
Spring View HospitalLebanon – – – –
Flaget Memorial HospitalBardstown – – – –
Murray-Calloway County HospitalMurray – – – –
Hazard Arh Regional Medical CenterHazard – – – –
Jewish HospitalLouisville – – – –
St Elizabeth FlorenceFlorence – – – –
Baptist Health RichmondRichmond – – – –
Harlan Appalachian Regional Healthcare HospitalHarlan – – – –
Jennie Stuart Medical CenterHopkinsville – – – –
Deaconess Henderson HospitalHenderson – – – –
Saint Joseph Mount SterlingMt Sterling – – – –
The Medical Center at RussellvilleRussellville – – – –
Twin Lakes Regional Medical CenterLeitchfield – – – –
Paintsville Arh HospitalPaintsville – – – –
Harrison Memorial HospitalCynthiana – – – –
Taylor Regional HospitalCampbellsville – – – –
Clark Regional Medical CenterWinchester – – – –
Georgetown Community HospitalGeorgetown – – – –
Jackson Purchase Medical CenterMayfield – – – –
Greenview Regional HospitalBowling Green – – – –
Frankfort Regional Medical CenterFrankfort – – – –
Lake Cumberland Regional HospitalSomerset – – – –
Baptist Hospital NortheastLa Grange – – – –
Kentucky River Medical CenterJackson – – – –
Level 1 Breast/Lymphatic Surgery and Related Procedures: all states All Kentucky hospitals Kentucky hospital finances
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Lowest and highest allowed amounts in Kentucky

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Highest

Owensboro Medical Health SystemOwensboro, KY$3,527
Baptist Health Deaconess MadisonvilleMadisonville, KY$3,527
Lourdes HospitalPaducah, KY$3,488
Western Baptist HospitalPaducah, KY$3,405
Central Baptist HospitalLexington, KY$3,301

Level 1 Breast/Lymphatic Surgery and Related Procedures in other states

Arkansas · $3,247 Iowa · $3,338 Kansas · $3,311 Missouri · $3,289 Ohio · $3,250 Oklahoma · $3,261 South Carolina · $3,257 West Virginia · $3,207

Questions

How much does level 1 breast/lymphatic surgery and related procedures cost in Kentucky?

In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 50 hospitals in Kentucky was billed at $22,953 on average, while the average medicare-allowed amount was $3,266, of which Medicare paid $2,590. 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 Kentucky, average charges were 7.0 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.