facebook tracking Level 4 Breast/Lymphatic Surgery and Related Procedures cost in Ohio: 28 hospitals compared (APC 5094)

Level 4 Breast/Lymphatic Surgery and Related Procedures in Ohio

What 28 hospitals in Ohio charged and were paid for level 4 breast/lymphatic surgery and related procedures (APC 5094), from 2024 Medicare claims.

APC 5094 Outpatient 2024 Medicare data
Average charge $90,874 Hospital list price billed
Average allowed $15,288 Medicare's payment + patient's share
Medicare paid $13,656 Average per service
State rank #8 of 23 1 = lowest average payment

Hospitals in Ohio billed an average of $90,874 for level 4 breast/lymphatic surgery and related procedures, about 5.9 times the average medicare-allowed amount of $15,288. That payment is 11% below the U.S. average of $17,182.

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 $15,288Billed $90,874

About 17¢ was paid for every $1 hospitals in Ohio billed for this service.

Ohio hospitals: level 4 breast/lymphatic surgery and related procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Cleveland Clinic - Main CampusCleveland 20 $78,171 $15,015 $13,383
Kettering Medical CenterKettering 11 $113,969 $15,784 $14,152
Riverside Methodist HospitalColumbus – – – –
Mount Carmel St Ann's HospitalWesterville – – – –
Jewish Hospital, LLCCincinnati – – – –
Firelands Community HospitalSandusky – – – –
Cleveland Clinic - Akron GeneralAkron – – – –
Mount Carmel HealthColumbus – – – –
Genesis Healthcare SystemZanesville – – – –
Miami Valley HospitalDayton – – – –
Mercy Hospital FairfieldFairfield – – – –
Toledo Hospital theToledo – – – –
Fairview HospitalCleveland – – – –
Aultman HospitalCanton – – – –
Mercy St Vincent Medical CenterToledo – – – –
Good Samaritan HospitalCincinnati – – – –
Marietta Memorial HospitalMarietta – – – –
Christ HospitalCincinnati – – – –
Bethesda North HospitalCincinnati – – – –
Hillcrest HospitalCleveland – – – –
Kettering Medical Center - SycamoreMiamisburg – – – –
Arthur G James Cancer HospitalColumbus – – – –
Mount Carmel New Albany Surgical HospitalNew Albany – – – –
Dublin Methodist HospitalDublin – – – –
Ohio Valley Medical Center, LLCSpringfield – – – –
University Hospitals Ahuja Medical CenterBeachwood – – – –
Cleveland Clinic Avon HospitalAvon – – – –
Kettering Health TroyTroy – – – –
Level 4 Breast/Lymphatic Surgery and Related Procedures: all states All Ohio hospitals Ohio hospital finances
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Level 4 Breast/Lymphatic Surgery and Related Procedures in other states

Arkansas · $15,076 Georgia · $15,586 Kansas · $15,416 Louisiana · $14,872 Oklahoma · $15,153 Tennessee · $14,684 Texas · $15,873 Virginia · $15,429

Questions

How much does level 4 breast/lymphatic surgery and related procedures cost in Ohio?

In 2024 Medicare data, level 4 breast/lymphatic surgery and related procedures (APC 5094) at 28 hospitals in Ohio was billed at $90,874 on average, while the average medicare-allowed amount was $15,288, of which Medicare paid $13,656. 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 Ohio, average charges were 5.9 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.