Level 3 ENT Procedures in South Dakota
What 12 hospitals in South Dakota charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.
Average charge
$3,700
Hospital list price billed
Average allowed
$1,469
Medicare's payment + patient's share
Medicare paid
$1,169
Average per service
State rank
#36 of 44
1 = lowest average payment
Hospitals in South Dakota billed an average of $3,700 for level 3 ent procedures, about 2.5 times the average medicare-allowed amount of $1,469. That payment is 5% 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 $1,469Billed $3,700
About 40¢ was paid for every $1 hospitals in South Dakota billed for this service.
South Dakota hospitals: level 3 ent procedures
Every South Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls | 29 | $4,628 | $1,430 | $1,139 |
| Spearfish Regional HospitalSpearfish | 22 | $2,820 | $1,531 | $1,220 |
| Sanford Usd Medical CenterSioux Falls | 15 | $2,691 | $1,402 | $1,117 |
| Rapid City Regional HospitalRapid City | 12 | $4,330 | $1,531 | $1,215 |
| Prairie Lakes Hosp & Care CtrWatertown | – | – | – | – |
| Avera Sacred Heart HospitalYankton | – | – | – | – |
| Avera St LukesAberdeen | – | – | – | – |
| St Mary's Healthcare CenterPierre | – | – | – | – |
| Dunes Surgical HospitalNorth Sioux City | – | – | – | – |
| Sioux Falls Surgical Hospital LLPSioux Falls | – | – | – | – |
| Black Hills Surgical Hospital LLPRapid City | – | – | – | – |
| Same Day Surgery Center LLCRapid City | – | – | – | – |
Lowest and highest allowed amounts in South Dakota
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
| Sanford Usd Medical CenterSioux Falls, SD | $1,402 |
|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $1,430 |
| Spearfish Regional HospitalSpearfish, SD | $1,531 |
| Rapid City Regional HospitalRapid City, SD | $1,531 |
Highest
| Rapid City Regional HospitalRapid City, SD | $1,531 |
|---|---|
| Spearfish Regional HospitalSpearfish, SD | $1,531 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $1,430 |
| Sanford Usd Medical CenterSioux Falls, SD | $1,402 |
Level 3 ENT Procedures in other states
Questions
How much does level 3 ent procedures cost in South Dakota?
In 2024 Medicare data, level 3 ent procedures (APC 5163) at 12 hospitals in South Dakota was billed at $3,700 on average, while the average medicare-allowed amount was $1,469, of which Medicare paid $1,169. 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 South Dakota, average charges were 2.5 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.