facebook tracking Level 3 ENT Procedures cost in Connecticut: 13 hospitals compared (APC 5163)

Level 3 ENT Procedures in Connecticut

What 13 hospitals in Connecticut charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.

APC 5163 Outpatient 2024 Medicare data
Average charge $9,168 Hospital list price billed
Average allowed $1,716 Medicare's payment + patient's share
Medicare paid $1,367 Average per service
State rank #42 of 44 1 = lowest average payment

Hospitals in Connecticut billed an average of $9,168 for level 3 ent procedures, about 5.3 times the average medicare-allowed amount of $1,716. That payment is 23% above the U.S. average 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.

Paid $1,716Billed $9,168

About 19¢ was paid for every $1 hospitals in Connecticut billed for this service.

Connecticut hospitals: level 3 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Yale-New Haven HospitalNew Haven 12 $9,168 $1,716 $1,367
Day Kimball HospitalPutnam – – – –
Stamford HospitalStamford – – – –
Bridgeport HospitalBridgeport – – – –
Charlotte Hungerford HospitalTorrington – – – –
Saint Marys HospitalWaterbury – – – –
Greenwich Hospital AssociationGreenwich – – – –
Middlesex HospitalMiddletown – – – –
William W Backus HospitalNorwich – – – –
Hartford HospitalHartford – – – –
Manchester Memorial HospitalCentral Manchester – – – –
Danbury HospitalDanbury – – – –
John Dempsey HospitalFarmington – – – –
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Level 3 ENT Procedures in other states

Questions

How much does level 3 ent procedures cost in Connecticut?

In 2024 Medicare data, level 3 ent procedures (APC 5163) at 13 hospitals in Connecticut was billed at $9,168 on average, while the average medicare-allowed amount was $1,716, of which Medicare paid $1,367. 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 Connecticut, average charges were 5.3 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.