Level 3 ENT Procedures in Kentucky
What 27 hospitals in Kentucky charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.
Average charge
$9,937
Hospital list price billed
Average allowed
$1,262
Medicare's payment + patient's share
Medicare paid
$996
Average per service
State rank
#14 of 44
1 = lowest average payment
Hospitals in Kentucky billed an average of $9,937 for level 3 ent procedures, about 7.9 times the average medicare-allowed amount of $1,262. That payment is 10% below 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 $1,262Billed $9,937
About 13¢ was paid for every $1 hospitals in Kentucky billed for this service.
Kentucky hospitals: level 3 ent procedures
Every Kentucky hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Kentucky
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
| Ephraim McDowell Regional Medical CenterDanville, KY | $1,026 |
|---|---|
| King's Daughters' Medical CenterAshland, KY | $1,250 |
| Pikeville Medical CenterPikeville, KY | $1,327 |
| Western Baptist HospitalPaducah, KY | $1,395 |
Highest
| Western Baptist HospitalPaducah, KY | $1,395 |
|---|---|
| Pikeville Medical CenterPikeville, KY | $1,327 |
| King's Daughters' Medical CenterAshland, KY | $1,250 |
| Ephraim McDowell Regional Medical CenterDanville, KY | $1,026 |
Level 3 ENT Procedures in other states
Questions
How much does level 3 ent procedures cost in Kentucky?
In 2024 Medicare data, level 3 ent procedures (APC 5163) at 27 hospitals in Kentucky was billed at $9,937 on average, while the average medicare-allowed amount was $1,262, of which Medicare paid $996. 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 7.9 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.