facebook tracking Level 3 Upper GI Procedures cost in Kentucky: 31 hospitals compared (APC 5303)

Level 3 Upper GI Procedures in Kentucky

What 31 hospitals in Kentucky charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.

APC 5303 Outpatient 2024 Medicare data
Average charge $22,760 Hospital list price billed
Average allowed $3,305 Medicare's payment + patient's share
Medicare paid $2,629 Average per service
State rank #12 of 48 1 = lowest average payment

Hospitals in Kentucky billed an average of $22,760 for level 3 upper gi procedures, about 6.9 times the average medicare-allowed amount of $3,305. That payment is 9% below the U.S. average of $3,633.

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 $3,305Billed $22,760

About 15¢ was paid for every $1 hospitals in Kentucky billed for this service.

Kentucky hospitals: level 3 upper 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
Norton Healthcare PavilionLouisville 80 $24,065 $3,284 $2,623
Jewish HospitalLouisville 52 $21,008 $3,300 $2,629
University of Kentucky HospLexington 44 $19,634 $3,241 $2,576
Ephraim McDowell Regional Medical CenterDanville 32 $11,664 $3,296 $2,626
Owensboro Medical Health SystemOwensboro 31 $36,130 $3,543 $2,823
Saint Joseph HospitalLexington 22 $19,267 $3,196 $2,522
Lourdes HospitalPaducah 20 $13,218 $3,504 $2,787
St Elizabeth Med Center-SouthEdgewood 17 $22,944 $3,140 $2,470
Georgetown Community HospitalGeorgetown 15 $29,593 $3,331 $2,654
Central Baptist HospitalLexington 14 $26,035 $3,317 $2,642
Baptist Hospital EastLouisville 14 $34,408 $3,218 $2,547
King's Daughters' Medical CenterAshland 12 $22,658 $3,262 $2,599
Hardin Memorial HospitalElizabethtown 11 $24,507 $3,300 $2,622
The Medical Center at Bowling GreenBowling Green – – – –
T J Samson Community HospitalGlasgow – – – –
St Claire Regional Medical CenterMorehead – – – –
Murray-Calloway County HospitalMurray – – – –
Hazard Arh Regional Medical CenterHazard – – – –
Pikeville Medical CenterPikeville – – – –
St Elizabeth FlorenceFlorence – – – –
Bourbon Community HospitalParis – – – –
Harrison Memorial HospitalCynthiana – – – –
Taylor Regional HospitalCampbellsville – – – –
Clark Regional Medical CenterWinchester – – – –
Baptist Health Deaconess MadisonvilleMadisonville – – – –
Jackson Purchase Medical CenterMayfield – – – –
Greenview Regional HospitalBowling Green – – – –
Three Rivers Medical CenterLouisa – – – –
Lake Cumberland Regional HospitalSomerset – – – –
Baptist Hospital NortheastLa Grange – – – –
University of Louisville HospitalLouisville – – – –
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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

St Elizabeth Med Center-SouthEdgewood, KY$3,140
Saint Joseph HospitalLexington, KY$3,196
Baptist Hospital EastLouisville, KY$3,218
University of Kentucky HospLexington, KY$3,241
King's Daughters' Medical CenterAshland, KY$3,262

Highest

Owensboro Medical Health SystemOwensboro, KY$3,543
Lourdes HospitalPaducah, KY$3,504
Georgetown Community HospitalGeorgetown, KY$3,331
Central Baptist HospitalLexington, KY$3,317
Hardin Memorial HospitalElizabethtown, KY$3,300

Level 3 Upper GI Procedures in other states

Questions

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

In 2024 Medicare data, level 3 upper gi procedures (APC 5303) at 31 hospitals in Kentucky was billed at $22,760 on average, while the average medicare-allowed amount was $3,305, of which Medicare paid $2,629. 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 6.9 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.