facebook tracking Level 3 Lower GI Procedures cost in Kentucky: 48 hospitals compared (APC 5313)

Level 3 Lower GI Procedures in Kentucky

What 48 hospitals in Kentucky charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.

APC 5313 Outpatient 2024 Medicare data
Average charge $17,186 Hospital list price billed
Average allowed $2,374 Medicare's payment + patient's share
Medicare paid $1,920 Average per service
State rank #10 of 49 1 = lowest average payment

Hospitals in Kentucky billed an average of $17,186 for level 3 lower gi procedures, about 7.2 times the average medicare-allowed amount of $2,374. That payment is 12% below the U.S. average of $2,703.

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 $2,374Billed $17,186

About 14¢ was paid for every $1 hospitals in Kentucky billed for this service.

Kentucky hospitals: level 3 lower gi procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Hardin Memorial HospitalElizabethtown 90 $20,533 $2,418 $1,995
Jewish HospitalLouisville 57 $13,420 $2,385 $1,911
St Elizabeth Med Center-SouthEdgewood 50 $15,017 $2,338 $1,872
King's Daughters' Medical CenterAshland 49 $17,036 $2,311 $1,865
Murray-Calloway County HospitalMurray 35 $10,882 $2,355 $1,926
St Elizabeth FlorenceFlorence 32 $16,430 $2,375 $1,980
University of Kentucky HospLexington 30 $17,126 $2,109 $1,622
Norton Healthcare PavilionLouisville 29 $14,001 $2,412 $1,930
Baptist Hospital EastLouisville 28 $27,318 $2,419 $1,931
Ephraim McDowell Regional Medical CenterDanville 17 $9,387 $2,416 $1,940
University of Louisville HospitalLouisville 17 $19,596 $2,419 $1,922
Baptist Health RichmondRichmond 13 $27,944 $2,415 $1,999
Baptist Health Deaconess MadisonvilleMadisonville 12 $25,286 $2,598 $2,070
St Elizabeth Ft ThomasFort Thomas 11 $17,250 $2,441 $1,990
Deaconess Henderson HospitalHenderson 11 $11,573 $2,472 $2,038
Highlands Regional Medical CenterPrestonsburg – – – –
Saint Joseph HospitalLexington – – – –
Saint Joseph LondonLondon – – – –
The Medical Center at Bowling GreenBowling Green – – – –
Jewish Hospital - ShelbyvilleShelbyville – – – –
T J Samson Community HospitalGlasgow – – – –
St Claire Regional Medical CenterMorehead – – – –
Middlesboro Appalachian Regional Healthcare HospitMiddlesboro – – – –
Spring View HospitalLebanon – – – –
Flaget Memorial HospitalBardstown – – – –
Hazard Arh Regional Medical CenterHazard – – – –
Owensboro Medical Health SystemOwensboro – – – –
Pikeville Medical CenterPikeville – – – –
Harlan Appalachian Regional Healthcare HospitalHarlan – – – –
Jennie Stuart Medical CenterHopkinsville – – – –
Williamson Arh HospitalSouth Williamson – – – –
Harrison Memorial HospitalCynthiana – – – –
Baptist Regional Medical CtrCorbin – – – –
Taylor Regional HospitalCampbellsville – – – –
Clark Regional Medical CenterWinchester – – – –
Georgetown Community HospitalGeorgetown – – – –
Lourdes HospitalPaducah – – – –
Central Baptist HospitalLexington – – – –
Western Baptist HospitalPaducah – – – –
Rockcastle Reg Hospital & Respiratory Care CtrMt Vernon – – – –
Jackson Purchase Medical CenterMayfield – – – –
Greenview Regional HospitalBowling Green – – – –
Frankfort Regional Medical CenterFrankfort – – – –
Three Rivers Medical CenterLouisa – – – –
Lake Cumberland Regional HospitalSomerset – – – –
Baptist Hospital NortheastLa Grange – – – –
Kentucky River Medical CenterJackson – – – –
Crittenden Community HospitalMarion – – – –
Advertisement

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

Highest

Baptist Health Deaconess MadisonvilleMadisonville, KY$2,598
Deaconess Henderson HospitalHenderson, KY$2,472
St Elizabeth Ft ThomasFort Thomas, KY$2,441
University of Louisville HospitalLouisville, KY$2,419
Baptist Hospital EastLouisville, KY$2,419

Level 3 Lower GI Procedures in other states

Questions

How much does level 3 lower gi procedures cost in Kentucky?

In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 48 hospitals in Kentucky was billed at $17,186 on average, while the average medicare-allowed amount was $2,374, of which Medicare paid $1,920. 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 7.2 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.