What 18 hospitals in West Virginia charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.
Hospitals in West Virginia billed an average of $5,592 for level 3 ent procedures, about 4.5 times the average medicare-allowed amount of $1,241. That payment is 11% 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.
About 22¢ was paid for every $1 hospitals in West Virginia billed for this service.
Every West Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 40 | $5,857 | $1,151 | $892 |
| United Hospital CenterBridgeport | 16 | $3,807 | $1,384 | $1,088 |
| Princeton Community HospitalPrinceton | 16 | $5,060 | $1,211 | $951 |
| Berkeley Medical CenterMartinsburg | 14 | $4,643 | $1,340 | $1,068 |
| Wheeling HospitalWheeling | 11 | $9,205 | $1,276 | $1,017 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| St Mary's Medical CenterHuntington | – | – | – | – |
| Reynolds Memorial HospitalGlen Dale | – | – | – | – |
| Charleston Area Medical CenterCharleston | – | – | – | – |
| Weirton Medical CenterWeirton | – | – | – | – |
| Thomas Memorial HospitalSouth Charleston | – | – | – | – |
| Davis Memorial HospitalElkins | – | – | – | – |
| Saint Francis HospitalCharleston | – | – | – | – |
| Stonewall Jackson Mem HospWeston | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
| Camden Clark Memorial HospitalParkersburg | – | – | – | – |
| Beckley Arh HospitalBeckley | – | – | – | – |
| Camc Charleston Surgical HospitalCharleston | – | – | – | – |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| West Virginia University HospitalsMorgantown, WV | $1,151 |
|---|---|
| Princeton Community HospitalPrinceton, WV | $1,211 |
| Wheeling HospitalWheeling, WV | $1,276 |
| Berkeley Medical CenterMartinsburg, WV | $1,340 |
| United Hospital CenterBridgeport, WV | $1,384 |
| United Hospital CenterBridgeport, WV | $1,384 |
|---|---|
| Berkeley Medical CenterMartinsburg, WV | $1,340 |
| Wheeling HospitalWheeling, WV | $1,276 |
| Princeton Community HospitalPrinceton, WV | $1,211 |
| West Virginia University HospitalsMorgantown, WV | $1,151 |
In 2024 Medicare data, level 3 ent procedures (APC 5163) at 18 hospitals in West Virginia was billed at $5,592 on average, while the average medicare-allowed amount was $1,241, of which Medicare paid $973. Your own cost depends on your insurance, deductible and the hospital.
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 West Virginia, average charges were 4.5 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.