Level 3 Lower GI Procedures in Massachusetts
What 49 hospitals in Massachusetts charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$10,302
Hospital list price billed
Average allowed
$2,977
Medicare's payment + patient's share
Medicare paid
$2,406
Average per service
State rank
#43 of 49
1 = lowest average payment
Hospitals in Massachusetts billed an average of $10,302 for level 3 lower gi procedures, about 3.5 times the average medicare-allowed amount of $2,977. That payment is 10% above 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 $2,977Billed $10,302
About 29¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 3 lower gi procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Massachusetts General HospitalBoston | 148 | $13,338 | $2,973 | $2,387 |
| Lahey Clinic HospitalBurlington | 142 | $9,337 | $3,015 | $2,446 |
| Beth Israel Deaconess Medical CenterBoston | 138 | $8,989 | $2,950 | $2,374 |
| Umass Memorial Medical Center INCWorcester | 109 | $19,195 | $2,979 | $2,399 |
| Beverly Hospital CorporationBeverly | 102 | $13,391 | $2,975 | $2,471 |
| Brigham and Women's HosptialBoston | 76 | $15,246 | $2,920 | $2,339 |
| Southcoast Hospital Group, INCFall River | 73 | $12,366 | $2,994 | $2,409 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | 71 | $6,011 | $2,857 | $2,272 |
| Newton-Wellesley HospitalNewton Lower Falls | 70 | $8,615 | $3,014 | $2,490 |
| Baystate Medical CenterSpringfield | 60 | $8,013 | $3,015 | $2,407 |
| Tufts Medical CenterBoston | 60 | $11,556 | $2,924 | $2,365 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 50 | $9,793 | $2,967 | $2,379 |
| Lowell General HospitalLowell | 45 | $7,009 | $3,015 | $2,424 |
| Mount Auburn HospitalCambridge | 41 | $8,640 | $3,014 | $2,476 |
| Milford Regional Medical CenterMilford | 39 | $3,959 | $3,013 | $2,514 |
| Emerson HospitalConcord | 34 | $7,620 | $3,015 | $2,404 |
| Union HospitalLynn | 30 | $12,983 | $3,014 | $2,476 |
| Melrosewakefield HealthcareMelrose | 29 | $6,760 | $3,015 | $2,427 |
| South Shore HospitalSouth Weymouth | 26 | $4,259 | $2,923 | $2,310 |
| Sturdy Memorial HospitalAttleboro | 24 | $6,057 | $2,918 | $2,381 |
| Winchester HospitalWinchester | 24 | $7,703 | $3,015 | $2,446 |
| Berkshire Medical Center INCPittsfield | 23 | $15,341 | $3,056 | $2,448 |
| Boston Medical Center-BrightonBrighton | 22 | $5,789 | $2,898 | $2,339 |
| Milton HospitalMilton | 21 | $4,923 | $2,943 | $2,381 |
| Boston Medical Center CorporationBoston | 19 | $5,802 | $3,015 | $2,408 |
| Beth Israel Deaconess Hospital - NeedhamNeedham | 19 | $4,397 | $3,015 | $2,403 |
| Cape Cod HospitalHyannis | 18 | $8,649 | $3,015 | $2,411 |
| Faulkner HospitalBoston | 17 | $9,317 | $3,015 | $2,429 |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | 16 | $8,771 | $3,015 | $2,409 |
| New England Baptist HospitalBoston | 14 | $5,233 | $2,886 | $2,300 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 13 | $12,313 | $3,015 | $2,414 |
| Anna Jaques HospitalNewburyport | 12 | $6,186 | $3,014 | $2,453 |
| Brockton HospitalBrockton | 12 | $7,425 | $3,015 | $2,446 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 12 | $6,968 | $3,015 | $2,415 |
| Healthalliance Hospitals, INCLeominster | – | – | – | – |
| Lawrence General HospitalLawrence | – | – | – | – |
| Cambridge Health AllianceCambridge | – | – | – | – |
| Baystate Franklin Medical CenterGreenfield | – | – | – | – |
| Carney HospitalDorchester | – | – | – | – |
| Harrington Memorial HospitalSouthbridge | – | – | – | – |
| Holyoke Medical CenterHolyoke | – | – | – | – |
| Wing Memorial Hospital and Medical CenterPalmer | – | – | – | – |
| Marlborough HospitalMarlborough | – | – | – | – |
| Mercy Medical CenterSpringfield | – | – | – | – |
| Morton Hospital & Medical CenterTaunton | – | – | – | – |
| Heywood HospitalGardner | – | – | – | – |
| Falmouth HospitalFalmouth | – | – | – | – |
| Metrowest Medical CenterFramingham | – | – | – | – |
| St Vincent HospitalWorcester | – | – | – | – |
Lowest and highest allowed amounts in Massachusetts
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
| Saint Anne's Hospital, a Caritas Family HospitalFall River, MA | $2,857 |
|---|---|
| New England Baptist HospitalBoston, MA | $2,886 |
| Boston Medical Center-BrightonBrighton, MA | $2,898 |
| Sturdy Memorial HospitalAttleboro, MA | $2,918 |
| Brigham and Women's HosptialBoston, MA | $2,920 |
Highest
| Berkshire Medical Center INCPittsfield, MA | $3,056 |
|---|---|
| Beth Israel Deaconess Hospital - NeedhamNeedham, MA | $3,015 |
| Emerson HospitalConcord, MA | $3,015 |
| Baystate Medical CenterSpringfield, MA | $3,015 |
| Boston Medical Center CorporationBoston, MA | $3,015 |
Level 3 Lower GI Procedures in other states
Questions
How much does level 3 lower gi procedures cost in Massachusetts?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 49 hospitals in Massachusetts was billed at $10,302 on average, while the average medicare-allowed amount was $2,977, of which Medicare paid $2,406. 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 Massachusetts, average charges were 3.5 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.