Level 3 Upper GI Procedures in West Virginia
What 14 hospitals in West Virginia charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.
Average charge
$15,398
Hospital list price billed
Average allowed
$3,241
Medicare's payment + patient's share
Medicare paid
$2,570
Average per service
State rank
#5 of 48
1 = lowest average payment
Hospitals in West Virginia billed an average of $15,398 for level 3 upper gi procedures, about 4.8 times the average medicare-allowed amount of $3,241. That payment is 11% 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 $3,241Billed $15,398
About 21¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 3 upper gi procedures
Every West Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 69 | $12,010 | $3,167 | $2,514 |
| Cabell-Huntington Hospital INCHuntington | 33 | $22,346 | $3,184 | $2,515 |
| Charleston Area Medical CenterCharleston | 26 | $24,653 | $3,247 | $2,583 |
| Thomas Memorial HospitalSouth Charleston | 24 | $10,790 | $3,146 | $2,479 |
| United Hospital CenterBridgeport | 22 | $9,692 | $3,658 | $2,912 |
| St Mary's Medical CenterHuntington | – | – | – | – |
| Berkeley Medical CenterMartinsburg | – | – | – | – |
| Weirton Medical CenterWeirton | – | – | – | – |
| Mon Health Medical CenterMorgantown | – | – | – | – |
| Davis Memorial HospitalElkins | – | – | – | – |
| Princeton Community HospitalPrinceton | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
| Wheeling HospitalWheeling | – | – | – | – |
| Raleigh General HospitalBeckley | – | – | – | – |
Lowest and highest allowed amounts in West Virginia
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
| Thomas Memorial HospitalSouth Charleston, WV | $3,146 |
|---|---|
| West Virginia University HospitalsMorgantown, WV | $3,167 |
| Cabell-Huntington Hospital INCHuntington, WV | $3,184 |
| Charleston Area Medical CenterCharleston, WV | $3,247 |
| United Hospital CenterBridgeport, WV | $3,658 |
Highest
| United Hospital CenterBridgeport, WV | $3,658 |
|---|---|
| Charleston Area Medical CenterCharleston, WV | $3,247 |
| Cabell-Huntington Hospital INCHuntington, WV | $3,184 |
| West Virginia University HospitalsMorgantown, WV | $3,167 |
| Thomas Memorial HospitalSouth Charleston, WV | $3,146 |
Level 3 Upper GI Procedures in other states
Questions
How much does level 3 upper gi procedures cost in West Virginia?
In 2024 Medicare data, level 3 upper gi procedures (APC 5303) at 14 hospitals in West Virginia was billed at $15,398 on average, while the average medicare-allowed amount was $3,241, of which Medicare paid $2,570. 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 West Virginia, average charges were 4.8 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.