facebook tracking Level 1 ICD and Similar Procedures cost in Indiana: 34 hospitals compared (APC 5231)

Level 1 ICD and Similar Procedures in Indiana

What 34 hospitals in Indiana charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.

APC 5231 Outpatient 2024 Medicare data
Average charge $76,141 Hospital list price billed
Average allowed $21,143 Medicare's payment + patient's share
Medicare paid $19,505 Average per service
State rank #18 of 34 1 = lowest average payment

Hospitals in Indiana billed an average of $76,141 for level 1 icd and similar procedures, about 3.6 times the average medicare-allowed amount of $21,143. That payment is 7% below the U.S. average of $22,647.

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 $21,143Billed $76,141

About 28¢ was paid for every $1 hospitals in Indiana billed for this service.

Indiana hospitals: level 1 icd and similar procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Deaconess Hospital INCEvansville 20 $69,733 $20,942 $19,310
St Vincent Hospital & Health ServicesIndianapolis 15 $82,092 $21,060 $19,428
St Vincent Heart Center of Indiana LLCIndianapolis 12 $72,150 $21,237 $19,597
Union Hospital INCTerre Haute 11 $89,151 $21,237 $19,583
Clarian Health PartnersIndianapolis 11 $71,023 $21,423 $19,786
La Porte Regional Health SystLa Porte – – – –
Marion General HospitalMarion – – – –
Saint Joseph Reg Medical CtrSouth Bend – – – –
Franciscan St Anthony Health - Michigan CityMichigan City – – – –
Lutheran Hospital of IndianaFort Wayne – – – –
Elkhart General HospitalElkhart – – – –
Parkview HospitalFort Wayne – – – –
IU Health Goshen HospitalGoshen – – – –
St Mary Medical Center INCHobart – – – –
Porter, Valparaiso HospitalValparaiso – – – –
Floyd Memorial Hospital and Health ServicesNew Albany – – – –
Terre Haute Regional HospitalTerre Haute – – – –
Reid Hosp & Hlth Care ServicesRichmond – – – –
Bloomington HospitalBloomington – – – –
Memorial Hospital of South BendSouth Bend – – – –
Riverview HospitalNoblesville – – – –
Community Hospital EastIndianapolis – – – –
Ball Memorial Hospital INCMuncie – – – –
Franciscan St Margaret Health - DyerDyer – – – –
St Mary's Medical Center of Evansville INCEvansville – – – –
Columbus Regional HospitalColumbus – – – –
Memorial Hospital and Health Care CenterJasper – – – –
Community HospitalMunster – – – –
Franciscan St Anthony Health - Crown PointCrown Point – – – –
Community Hospital SouthIndianapolis – – – –
Kosciusko Community HospitalWarsaw – – – –
Franciscan Health IndianapolisIndianapolis – – – –
Pinnacle HospitalCrown Point – – – –
Indiana University Health Arnett HospitalLafayette – – – –
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Lowest and highest allowed amounts in Indiana

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

Deaconess Hospital INCEvansville, IN$20,942
St Vincent Hospital & Health ServicesIndianapolis, IN$21,060
St Vincent Heart Center of Indiana LLCIndianapolis, IN$21,237
Union Hospital INCTerre Haute, IN$21,237
Clarian Health PartnersIndianapolis, IN$21,423

Highest

Clarian Health PartnersIndianapolis, IN$21,423
Union Hospital INCTerre Haute, IN$21,237
St Vincent Heart Center of Indiana LLCIndianapolis, IN$21,237
St Vincent Hospital & Health ServicesIndianapolis, IN$21,060
Deaconess Hospital INCEvansville, IN$20,942

Level 1 ICD and Similar Procedures in other states

Questions

How much does level 1 icd and similar procedures cost in Indiana?

In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 34 hospitals in Indiana was billed at $76,141 on average, while the average medicare-allowed amount was $21,143, of which Medicare paid $19,505. 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 Indiana, average charges were 3.6 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.