Level 3 ENT Procedures
What 1,383 hospitals in the U.S. charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.
Average charge
$6,801
Hospital list price billed
Average allowed
$1,397
Medicare's payment + patient's share
Medicare paid
$1,106
Average per service
Volume
5,010
Medicare services
Hospitals in the U.S. billed an average of $6,801 for level 3 ent procedures, about 4.9 times the average medicare-allowed amount of $1,397.
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
| Metrohealth SystemCleveland, OH | $516 |
|---|---|
| Carilion Medical CenterRoanoke, VA | $670 |
| Carle Foundation HospitalUrbana, IL | $733 |
| Fletcher Allen Hospital of VermontBurlington, VT | $749 |
| Blessing HospitalQuincy, IL | $766 |
| University of Kansas HospitalKansas City, KS | $772 |
| University Hospital, INCCincinnati, OH | $892 |
| The Nebraska Medical CenterOmaha, NE | $974 |
| CHRISTUS Central Louisiana Surgical HospitalAlexandria, LA | $1,145 |
| Mountain View HospitalIdaho Falls, ID | $1,148 |
Highest
| UCSF Medical CenterSan Francisco, CA | $2,148 |
|---|---|
| Stanford HospitalPalo Alto, CA | $2,118 |
| Sonora Community HospitalSonora, CA | $1,939 |
| University of California Davis Medical CenterSacramento, CA | $1,901 |
| Community Memorial Hospital - VenturaVentura, CA | $1,875 |
| USC University HospitalLos Angeles, CA | $1,875 |
| Enloe Medical CenterChico, CA | $1,793 |
| University of California San Diego Medical CenterSan Diego, CA | $1,754 |
| Mem Sloan-Kettering Cancer CtrNew York, NY | $1,735 |
| UCI Health-OrangeOrange, CA | $1,700 |
Level 3 ENT Procedures 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 | 28 | $11,834 | $1,273 | $1,273 – $1,273 |
| Alaska | 3 | – | – | – – – |
| Arizona | 18 | $3,340 | $774 | $761 – $783 |
| Arkansas | 16 | $4,192 | $1,307 | $1,307 – $1,307 |
| California | 100 | $7,200 | $1,911 | $1,700 – $2,148 |
| Colorado | 25 | $8,598 | $1,452 | $1,452 – $1,452 |
| Connecticut | 13 | $9,168 | $1,716 | $1,716 – $1,716 |
| Delaware | 5 | $7,876 | $1,530 | $1,530 – $1,530 |
| Florida | 66 | $9,637 | $1,347 | $1,040 – $1,382 |
| Georgia | 41 | $10,636 | $1,354 | $1,249 – $1,415 |
| Hawaii | 7 | – | – | – – – |
| Idaho | 10 | $1,446 | $1,260 | $1,148 – $1,397 |
| Illinois | 57 | $6,819 | $1,243 | $733 – $1,483 |
| Indiana | 39 | $14,134 | $1,378 | $1,359 – $1,434 |
| Iowa | 19 | $5,628 | $1,352 | $1,201 – $1,478 |
| Kansas | 17 | $6,057 | $873 | $772 – $1,394 |
| Kentucky | 27 | $9,937 | $1,262 | $1,026 – $1,395 |
| Louisiana | 35 | $11,275 | $1,159 | $994 – $1,268 |
| Maine | 11 | $5,884 | $1,393 | $1,329 – $1,433 |
| Massachusetts | 39 | $5,014 | $1,622 | $1,493 – $1,720 |
| Michigan | 58 | $5,700 | $1,334 | $798 – $1,411 |
| Minnesota | 25 | $5,223 | $1,457 | $1,417 – $1,563 |
| Mississippi | 19 | $6,632 | $1,086 | $512 – $1,262 |
| Missouri | 35 | $5,319 | $1,330 | $1,233 – $1,454 |
| Montana | 8 | $2,233 | $1,427 | $1,326 – $1,531 |
| Nebraska | 9 | $2,518 | $974 | $974 – $974 |
| Nevada | 9 | – | – | – – – |
| New Hampshire | 10 | $2,513 | $1,114 | $637 – $1,462 |
| New Jersey | 29 | $7,406 | $1,716 | $1,716 – $1,716 |
| New Mexico | 8 | $3,674 | $1,358 | $1,252 – $1,434 |
| New York | 67 | $7,813 | $1,631 | $1,323 – $1,735 |
| North Carolina | 38 | $6,201 | $1,320 | $1,286 – $1,393 |
| North Dakota | 5 | $1,417 | $1,430 | $1,430 – $1,430 |
| Ohio | 75 | $5,137 | $1,223 | $516 – $1,335 |
| Oklahoma | 30 | $14,401 | $1,299 | $1,051 – $1,407 |
| Oregon | 15 | $6,723 | $1,600 | $1,600 – $1,600 |
| Pennsylvania | 74 | $10,586 | $1,351 | $999 – $1,536 |
| Rhode Island | 5 | – | – | – – – |
| South Carolina | 16 | $15,234 | $1,316 | $1,316 – $1,316 |
| South Dakota | 12 | $3,700 | $1,469 | $1,402 – $1,531 |
| Tennessee | 27 | $8,377 | $1,203 | $1,175 – $1,300 |
| Texas | 94 | $6,507 | $1,383 | $1,342 – $1,414 |
| Utah | 14 | $3,992 | $1,366 | $1,366 – $1,366 |
| Vermont | 5 | $3,508 | $723 | $596 – $749 |
| Virginia | 33 | $4,100 | $1,192 | $670 – $1,400 |
| Washington | 23 | $3,861 | $1,473 | $784 – $1,651 |
| West Virginia | 18 | $5,592 | $1,241 | $1,151 – $1,384 |
| Wisconsin | 38 | $3,552 | $1,418 | $1,377 – $1,483 |
| Wyoming | 6 | – | – | – – – |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Cleveland Clinic - Main CampusCleveland, OH | 251 | $4,189 | $1,296 |
| Massachusetts Eye and Ear InfirmaryBoston, MA | 230 | $3,465 | $1,627 |
| Univ of Miami Hosp & ClinicsMiami, FL | 126 | $7,714 | $1,381 |
| UCI Health-OrangeOrange, CA | 109 | $3,631 | $1,700 |
| Community Memorial Hospital - VenturaVentura, CA | 100 | $173 | $1,875 |
| Mary Hitchcock Mem HospitalLebanon, NH | 90 | $2,831 | $1,149 |
| Vanderbilt University HospitalNashville, TN | 89 | $8,458 | $1,175 |
| UCSF Medical CenterSan Francisco, CA | 87 | $6,286 | $2,148 |
| MUSC Medical CenterCharleston, SC | 76 | $7,693 | $1,316 |
| Hospital of the Univ of PaPhiladelphia, PA | 75 | $6,068 | $1,192 |
| Stanford HospitalPalo Alto, CA | 72 | $19,543 | $2,118 |
| Univ of Michigan HospitalsAnn Arbor, MI | 70 | $8,777 | $1,411 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | 66 | $4,822 | $1,389 |
| University of Kansas HospitalKansas City, KS | 62 | $4,953 | $772 |
| University of California Davis Medical CenterSacramento, CA | 59 | $12,462 | $1,901 |
Questions
How much does level 3 ent procedures cost in the U.S.?
In 2024 Medicare data, level 3 ent procedures (APC 5163) at 1,383 hospitals in the U.S. was billed at $6,801 on average, while the average medicare-allowed amount was $1,397, of which Medicare paid $1,106. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 3 ent procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($1,911), New Jersey ($1,716), Connecticut ($1,716) and lowest in Vermont ($723), Arizona ($774), Kansas ($873).
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 4.9 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.