Level 1 ICD and Similar Procedures in Kentucky
What 20 hospitals in Kentucky charged and were paid for level 1 icd and similar procedures (APC 5231), from 2024 Medicare claims.
Average charge
$219,083
Hospital list price billed
Average allowed
$19,787
Medicare's payment + patient's share
Medicare paid
$18,155
Average per service
State rank
#4 of 34
1 = lowest average payment
Hospitals in Kentucky billed an average of $219,083 for level 1 icd and similar procedures, about 11.1 times the average medicare-allowed amount of $19,787. That payment is 13% 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 $19,787Billed $219,083
About 9¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 1 icd and similar 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 |
|---|---|---|---|---|
| Central Baptist HospitalLexington | 16 | $219,083 | $19,787 | $18,155 |
| King's Daughters' Medical CenterAshland | – | – | – | – |
| Saint Joseph HospitalLexington | – | – | – | – |
| Saint Joseph LondonLondon | – | – | – | – |
| Hardin Memorial HospitalElizabethtown | – | – | – | – |
| The Medical Center at Bowling GreenBowling Green | – | – | – | – |
| T J Samson Community HospitalGlasgow | – | – | – | – |
| St Claire Regional Medical CenterMorehead | – | – | – | – |
| St Elizabeth Med Center-SouthEdgewood | – | – | – | – |
| Owensboro Medical Health SystemOwensboro | – | – | – | – |
| Jewish HospitalLouisville | – | – | – | – |
| Memorial HospitalManchester | – | – | – | – |
| Ephraim McDowell Regional Medical CenterDanville | – | – | – | – |
| University of Kentucky HospLexington | – | – | – | – |
| Harrison Memorial HospitalCynthiana | – | – | – | – |
| Norton Healthcare PavilionLouisville | – | – | – | – |
| Baptist Health Deaconess MadisonvilleMadisonville | – | – | – | – |
| Greenview Regional HospitalBowling Green | – | – | – | – |
| Baptist Hospital EastLouisville | – | – | – | – |
| Lake Cumberland Regional HospitalSomerset | – | – | – | – |
Level 1 ICD and Similar Procedures in other states
Questions
How much does level 1 icd and similar procedures cost in Kentucky?
In 2024 Medicare data, level 1 icd and similar procedures (APC 5231) at 20 hospitals in Kentucky was billed at $219,083 on average, while the average medicare-allowed amount was $19,787, of which Medicare paid $18,155. 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 11.1 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.