facebook tracking Level 3 ENT Procedures cost in Wisconsin: 38 hospitals compared (APC 5163)

Level 3 ENT Procedures in Wisconsin

What 38 hospitals in Wisconsin charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.

APC 5163 Outpatient 2024 Medicare data
Average charge $3,552 Hospital list price billed
Average allowed $1,418 Medicare's payment + patient's share
Medicare paid $1,125 Average per service
State rank #31 of 44 1 = lowest average payment

Hospitals in Wisconsin billed an average of $3,552 for level 3 ent procedures, about 2.5 times the average medicare-allowed amount of $1,418. That payment is 1% 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 $1,418Billed $3,552

About 40¢ was paid for every $1 hospitals in Wisconsin billed for this service.

Wisconsin hospitals: level 3 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
University of Wi Hospitals & Clinics AuthorityMadison 66 $4,822 $1,389 $1,097
Luther Hospital Mayo Health SystemEau Claire 42 $2,505 $1,447 $1,153
Gundersen Luth Med CtrLa Crosse 24 $3,620 $1,377 $1,095
Beloit Mem HsptlBeloit 22 $1,828 $1,483 $1,180
Mayo Clinic Health System-Franciscan Medical CenterLa Crosse 13 $3,283 $1,437 $1,145
Waukesha Memorial HospitalWaukesha – – – –
St Elizabeth HsptlAppleton – – – –
Sacred Heart HospitalEau Claire – – – –
Monroe ClinicMonroe – – – –
Aspirus Wausau HospitalWausau – – – –
Aurora Med Ctr Manitowoc CtyTwo Rivers – – – –
Marshfield Medical CenterMarshfield – – – –
Aurora Med Center-Washington CountyHartford – – – –
Bellin Memorial HsptlGreen Bay – – – –
Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee – – – –
St Clare Hsptl Hlth SvcsBaraboo – – – –
Aurora Memorial Hsptl BurlingtonBurlington – – – –
Mercy Hlth Sys CorpJanesville – – – –
Fort HealthcareFort Atkinson – – – –
St Vincent HsptlGreen Bay – – – –
Meriter HsptlMadison – – – –
Sauk Prairie Mem HsptlPrairie du Sac – – – –
St Marys Hsptl Med CtrGreen Bay – – – –
Aurora Lakeland Med CtrElkhorn – – – –
Community Mem HsptlMenomonee Falls – – – –
Bay Area Med CtrMarinette – – – –
UW Hlth Partners - Watertown Regional Medical CtrWatertown – – – –
Aurora St Lukes Medical CenterMilwaukee – – – –
Aurora West Allis Medical CenterWest Allis – – – –
Appleton Med CtrAppleton – – – –
Froedtert Mem Lutheran HsptlMilwaukee – – – –
Aurora Med Ctr KenoshaKenosha – – – –
Aurora Baycare Med CtrGreen Bay – – – –
Oakleaf Surgical HospitalEau Claire – – – –
Aurora Medical CenterSummit – – – –
SSM Health St Mary's Hospital - JanesvilleJanesville – – – –
Marshfield Medical Center - Eau ClaireEau Claire – – – –
Marshfield Medical Center - MinocquaMinocqua – – – –
Level 3 ENT Procedures: all states All Wisconsin hospitals Wisconsin hospital finances
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Lowest and highest allowed amounts in Wisconsin

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Level 3 ENT Procedures in other states

Colorado · $1,452 Indiana · $1,378 Maine · $1,393 Minnesota · $1,457 Montana · $1,427 North Dakota · $1,430 South Dakota · $1,469 Texas · $1,383

Questions

How much does level 3 ent procedures cost in Wisconsin?

In 2024 Medicare data, level 3 ent procedures (APC 5163) at 38 hospitals in Wisconsin was billed at $3,552 on average, while the average medicare-allowed amount was $1,418, of which Medicare paid $1,125. 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 Wisconsin, 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.