facebook tracking Level 3 ENT Procedures cost in West Virginia: 18 hospitals compared (APC 5163)

Level 3 ENT Procedures in West Virginia

What 18 hospitals in West Virginia charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.

APC 5163 Outpatient 2024 Medicare data
Average charge $5,592 Hospital list price billed
Average allowed $1,241 Medicare's payment + patient's share
Medicare paid $973 Average per service
State rank #11 of 44 1 = lowest average payment

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.

Paid $1,241Billed $5,592

About 22¢ was paid for every $1 hospitals in West Virginia billed for this service.

West Virginia hospitals: level 3 ent procedures

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 – – – –
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Lowest and highest allowed amounts in West Virginia

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

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

Highest

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

Level 3 ENT Procedures in other states

Questions

How much does level 3 ent procedures cost in West Virginia?

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.

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 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.