facebook tracking Level 3 Lower GI Procedures cost in North Dakota: 5 hospitals compared (APC 5313)

Level 3 Lower GI Procedures in North Dakota

What 5 hospitals in North Dakota charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.

APC 5313 Outpatient 2024 Medicare data
Average charge $12,423 Hospital list price billed
Average allowed $2,631 Medicare's payment + patient's share
Medicare paid $2,155 Average per service
State rank #30 of 49 1 = lowest average payment

Hospitals in North Dakota billed an average of $12,423 for level 3 lower gi procedures, about 4.7 times the average medicare-allowed amount of $2,631. That payment is 3% 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 $2,631Billed $12,423

About 21¢ was paid for every $1 hospitals in North Dakota billed for this service.

North Dakota hospitals: level 3 lower gi procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Sanford Medical Center FargoFargo 204 $12,721 $2,631 $2,179
Sanford Medical Center BismarckBismarck 47 $13,274 $2,631 $2,151
Altru Health SystemGrand Forks 35 $9,237 $2,691 $2,106
Essentia Health-FargoFargo 16 $13,081 $2,501 $1,966
Trinity HospitalsMinot – – – –
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Lowest and highest allowed amounts in North Dakota

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

Essentia Health-FargoFargo, ND$2,501
Sanford Medical Center FargoFargo, ND$2,631
Sanford Medical Center BismarckBismarck, ND$2,631
Altru Health SystemGrand Forks, ND$2,691

Highest

Altru Health SystemGrand Forks, ND$2,691
Sanford Medical Center BismarckBismarck, ND$2,631
Sanford Medical Center FargoFargo, ND$2,631
Essentia Health-FargoFargo, ND$2,501

Level 3 Lower GI Procedures in other states

Questions

How much does level 3 lower gi procedures cost in North Dakota?

In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 5 hospitals in North Dakota was billed at $12,423 on average, while the average medicare-allowed amount was $2,631, of which Medicare paid $2,155. 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 North Dakota, average charges were 4.7 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.