Level 1 Breast/Lymphatic Surgery and Related Procedures in Ohio
What 102 hospitals in Ohio charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$25,939
Hospital list price billed
Average allowed
$3,250
Medicare's payment + patient's share
Medicare paid
$2,575
Average per service
State rank
#8 of 49
1 = lowest average payment
Hospitals in Ohio billed an average of $25,939 for level 1 breast/lymphatic surgery and related procedures, about 8.0 times the average medicare-allowed amount of $3,250. That payment is 12% 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 $3,250Billed $25,939
About 13¢ was paid for every $1 hospitals in Ohio billed for this service.
Ohio hospitals: level 1 breast/lymphatic surgery and related procedures
Every Ohio hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Cleveland Clinic - Main CampusCleveland | 200 | $22,095 | $3,233 | $2,573 |
| Arthur G James Cancer HospitalColumbus | 119 | $32,137 | $3,386 | $2,693 |
| Kettering Medical CenterKettering | 91 | $31,362 | $3,391 | $2,695 |
| Toledo Hospital theToledo | 69 | $30,690 | $3,328 | $2,632 |
| Miami Valley HospitalDayton | 65 | $29,877 | $3,337 | $2,658 |
| Christ HospitalCincinnati | 64 | $20,099 | $3,231 | $2,553 |
| Fairview HospitalCleveland | 61 | $22,725 | $3,254 | $2,593 |
| Jewish Hospital, LLCCincinnati | 50 | $35,572 | $3,266 | $2,590 |
| Hillcrest HospitalCleveland | 48 | $24,726 | $3,146 | $2,485 |
| St Rita's Medical CenterLima | 47 | $32,139 | $3,205 | $2,535 |
| Riverside Methodist HospitalColumbus | 44 | $38,481 | $3,347 | $2,652 |
| Bethesda North HospitalCincinnati | 44 | $15,278 | $3,315 | $2,641 |
| University Hospitals Ahuja Medical CenterBeachwood | 41 | $22,111 | $3,254 | $2,593 |
| Dublin Methodist HospitalDublin | 40 | $37,399 | $3,341 | $2,648 |
| Summa Health System - Akron CampusAkron | 38 | $20,719 | $3,175 | $2,516 |
| Cleveland Clinic - Akron GeneralAkron | 37 | $21,162 | $3,243 | $2,584 |
| Firelands Community HospitalSandusky | 32 | $15,721 | $3,163 | $2,502 |
| Cleveland Clinic Avon HospitalAvon | 32 | $17,482 | $3,254 | $2,593 |
| Grant Medical CenterColumbus | 31 | $40,374 | $3,233 | $2,539 |
| Aultman HospitalCanton | 31 | $13,033 | $3,160 | $2,501 |
| University Hospital, INCCincinnati | 30 | $37,933 | $3,249 | $2,588 |
| Mount Carmel St Ann's HospitalWesterville | 29 | $26,903 | $3,322 | $2,622 |
| Mercy St Vincent Medical CenterToledo | 29 | $40,152 | $3,404 | $2,712 |
| Mercy Medical CenterCanton | 28 | $20,029 | $3,243 | $2,584 |
| St Elizabeth Health CenterYoungstown | 27 | $26,361 | $3,243 | $2,584 |
| Good Samaritan HospitalCincinnati | 27 | $17,373 | $3,315 | $2,641 |
| West Chester Medical CenterWest Chester | 27 | $27,667 | $3,315 | $2,641 |
| Genesis Healthcare SystemZanesville | 26 | $15,657 | $3,573 | $2,847 |
| Marietta Memorial HospitalMarietta | 25 | $20,202 | $2,107 | $1,441 |
| Surgical Hospital at SouthwoodsYoungstown | 25 | $11,705 | $3,243 | $2,584 |
| Mercy Hospital AndersonCincinnati | 24 | $31,556 | $3,205 | $2,526 |
| Lake Hospital SystemPainesville | 23 | $20,258 | $3,254 | $2,593 |
| Blanchard Valley Health AssnFindlay | 21 | $12,543 | $3,253 | $2,592 |
| UH Regional HospitalsRichmond Heights | 20 | $29,423 | $3,254 | $2,593 |
| University Hospitals of ClevelandCleveland | 20 | $35,100 | $3,254 | $2,593 |
| Parma Community General HospitalParma | 19 | $22,264 | $2,981 | $2,320 |
| Mount Carmel New Albany Surgical HospitalNew Albany | 19 | $19,351 | $3,409 | $2,716 |
| Metrohealth SystemCleveland | 18 | $18,412 | $1,526 | $864 |
| Ohiohealth Mansfield HospitalMansfield | 18 | $31,663 | $3,337 | $2,658 |
| St John Medical CenterWestlake | 18 | $25,974 | $3,254 | $2,593 |
| Mercy Franciscan Hospital - Mt AiryCincinnati | 18 | $24,543 | $3,315 | $2,641 |
| Mount Carmel HealthColumbus | 17 | $20,634 | $3,249 | $2,556 |
| Soin Medical CenterBeaver Creek | 17 | $34,943 | $3,421 | $2,726 |
| Marion General HospitalMarion | 16 | $33,110 | $3,337 | $2,647 |
| Adena Regional Medical CenterChillicothe | 16 | $27,156 | $3,337 | $2,658 |
| Mercy Hospital FairfieldFairfield | 15 | $33,799 | $3,315 | $2,641 |
| Trinity Medical Ctr East&Trinity Medical Ctr WestSteubenville | 14 | $15,150 | $3,243 | $2,584 |
| Wooster Community HospitalWooster | 13 | $7,915 | $3,261 | $2,598 |
| Fairfield Medical CenterLancaster | 13 | $25,792 | $3,409 | $2,709 |
| University Hospitals - Elyria Medical CenterElyria | 13 | $25,977 | $3,254 | $2,593 |
| Southern Ohio Medical CenterPortsmouth | 12 | $26,149 | $3,474 | $2,765 |
| Samaritan Hospital - Peoples HospitalAshland | – | – | – | – |
| Lima Memorial Health SystemLima | – | – | – | – |
| Union HospitalDover | – | – | – | – |
| Wilson Memorial HospitalSidney | – | – | – | – |
| Wood County HospitalBowling Green | – | – | – | – |
| Grand Lake Health SystemSt Marys | – | – | – | – |
| Knox Community HospitalMt Vernon | – | – | – | – |
| Wayne HospitalGreenville | – | – | – | – |
| University of Toledo Medical CenterToledo | – | – | – | – |
| Holzer Medical CenterGallipolis | – | – | – | – |
| Mercer County Joint Township Community HospitalColdwater | – | – | – | – |
| Fisher Titus Memorial HospitalNorwalk | – | – | – | – |
| Van Wert County HospitalVan Wert | – | – | – | – |
| Atrium Medical CenterMiddletown | – | – | – | – |
| University Hospitals Portage Medical CenterRavenna | – | – | – | – |
| Ohio State University HospitalsColumbus | – | – | – | – |
| Springfield Regional Medical CenterSpringfield | – | – | – | – |
| Medina HospitalMedina | – | – | – | – |
| Memorial Hospital of Union CountyMarysville | – | – | – | – |
| Bellevue HospitalBellevue | – | – | – | – |
| Coshocton County Memorial HospitalCoshocton | – | – | – | – |
| Community Hospitals and Wellness CentersBryan | – | – | – | – |
| Ashtabula County Medical CenterAshtabula | – | – | – | – |
| Fort Hamilton Hughes Memorial HospitalHamilton | – | – | – | – |
| Kettering Health DaytonDayton | – | – | – | – |
| Marymount HospitalGarfield Heights | – | – | – | – |
| South Pointe HospitalWarrensville Heights | – | – | – | – |
| Joel Pomerene Memorial HospitalMillersburg | – | – | – | – |
| Summa Western Reserve HospitalCuyahoga Falls | – | – | – | – |
| Doctors HospitalColumbus | – | – | – | – |
| Southwest General Health CenterMiddleburg Heights | – | – | – | – |
| Memorial HospitalFremont | – | – | – | – |
| St Joseph Health CenterWarren | – | – | – | – |
| Berger HospitalCircleville | – | – | – | – |
| Mercy Regional Medical CenterLorain | – | – | – | – |
| Upper Valley Medical CenterTroy | – | – | – | – |
| Trihealth Clinton Regional HospitalWilmington | – | – | – | – |
| Salem Community HospitalSalem | – | – | – | – |
| Madison County Hospital INCLondon | – | – | – | – |
| Mary Rutan HospitalBellefontaine | – | – | – | – |
| Southeastern Ohio Regional Medical CenterCambridge | – | – | – | – |
| Grady Memorial HospitalDelaware | – | – | – | – |
| Licking Memorial HospitalNewark | – | – | – | – |
| Mercy Hospital ClermontBatavia | – | – | – | – |
| Kettering Medical Center - SycamoreMiamisburg | – | – | – | – |
| Mercy Hospital of DefianceDefiance | – | – | – | – |
| St Elizabeth Boardman Health CenterYoungstown | – | – | – | – |
| Crystal Clinic Orthopaedic CenterAkron | – | – | – | – |
| Ohio Valley Medical Center, LLCSpringfield | – | – | – | – |
| Avita OntarioOntario | – | – | – | – |
| Kettering Health TroyTroy | – | – | – | – |
Lowest and highest allowed amounts in Ohio
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
| Metrohealth SystemCleveland, OH | $1,526 |
|---|---|
| Marietta Memorial HospitalMarietta, OH | $2,107 |
| Parma Community General HospitalParma, OH | $2,981 |
| Hillcrest HospitalCleveland, OH | $3,146 |
| Aultman HospitalCanton, OH | $3,160 |
Highest
| Genesis Healthcare SystemZanesville, OH | $3,573 |
|---|---|
| Southern Ohio Medical CenterPortsmouth, OH | $3,474 |
| Soin Medical CenterBeaver Creek, OH | $3,421 |
| Fairfield Medical CenterLancaster, OH | $3,409 |
| Mount Carmel New Albany Surgical HospitalNew Albany, OH | $3,409 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Ohio?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 102 hospitals in Ohio was billed at $25,939 on average, while the average medicare-allowed amount was $3,250, of which Medicare paid $2,575. 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 Ohio, average charges were 8.0 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.