Level 4 ENT Procedures
What 1,796 hospitals in the U.S. charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$20,680
Hospital list price billed
Average allowed
$2,798
Medicare's payment + patient's share
Medicare paid
$2,217
Average per service
Volume
10,268
Medicare services
Hospitals in the U.S. billed an average of $20,680 for level 4 ent procedures, about 7.4 times the average medicare-allowed amount of $2,798.
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.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| University of Mississippi Med CenterJackson, MS | $583 |
|---|---|
| Carle Foundation HospitalUrbana, IL | $658 |
| Mary Hitchcock Mem HospitalLebanon, NH | $760 |
| Clifton Springs Hospital and ClinicClifton Springs, NY | $853 |
| Community Regional Medical CenterFresno, CA | $1,501 |
| Duke University Medical CenterDurham, NC | $1,610 |
| University of Louisville HospitalLouisville, KY | $1,625 |
| Boston Medical Center CorporationBoston, MA | $1,763 |
| University of Minnesota Medical Center, FairviewMinneapolis, MN | $1,794 |
| Rochester General HospitalRochester, NY | $1,870 |
Highest
| UCSF Medical CenterSan Francisco, CA | $4,479 |
|---|---|
| Santa Barbara Cottage HospitalSanta Barbara, CA | $4,240 |
| Sonora Community HospitalSonora, CA | $4,239 |
| University of California Davis Medical CenterSacramento, CA | $4,013 |
| UCLA Medical CenterLos Angeles, CA | $3,958 |
| Orange County Global Medical CenterSanta Ana, CA | $3,958 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica, CA | $3,958 |
| Sharp Memorial HospitalSan Diego, CA | $3,958 |
| USC University HospitalLos Angeles, CA | $3,915 |
| University of California San Diego Medical CenterSan Diego, CA | $3,892 |
Level 4 ENT Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 36 | $33,763 | $2,668 | $2,549 – $2,688 |
| Alaska | 4 | $29,060 | $3,559 | $3,559 – $3,559 |
| Arizona | 25 | $23,037 | $3,081 | $2,731 – $3,362 |
| Arkansas | 24 | $11,734 | $2,803 | $2,535 – $2,957 |
| California | 149 | $32,769 | $3,847 | $1,501 – $4,509 |
| Colorado | 34 | $30,519 | $3,065 | $3,065 – $3,065 |
| Connecticut | 15 | $21,759 | $3,564 | $3,544 – $3,592 |
| Delaware | 6 | $13,748 | $3,230 | $3,230 – $3,230 |
| Florida | 99 | $38,824 | $2,835 | $2,397 – $2,916 |
| Georgia | 47 | $25,355 | $2,756 | $2,450 – $2,988 |
| Hawaii | 8 | $14,422 | $3,296 | $3,296 – $3,296 |
| Idaho | 13 | $14,486 | $2,653 | $1,530 – $2,999 |
| Illinois | 69 | $19,079 | $2,389 | $658 – $3,187 |
| Indiana | 46 | $21,399 | $2,875 | $2,661 – $3,074 |
| Iowa | 24 | $12,758 | $2,761 | $2,574 – $3,121 |
| Kansas | 22 | $22,855 | $2,598 | $2,075 – $2,944 |
| Kentucky | 30 | $18,958 | $2,468 | $1,625 – $2,946 |
| Louisiana | 41 | $16,884 | $2,647 | $2,312 – $2,791 |
| Maine | 14 | $13,077 | $2,846 | $2,673 – $3,025 |
| Massachusetts | 46 | $10,383 | $3,020 | $1,763 – $3,458 |
| Michigan | 62 | $20,401 | $2,863 | $2,510 – $2,945 |
| Minnesota | 39 | $17,288 | $2,893 | $1,794 – $3,297 |
| Mississippi | 23 | $6,340 | $878 | $583 – $2,695 |
| Missouri | 50 | $14,184 | $2,633 | $1,892 – $3,029 |
| Montana | 9 | $10,882 | $3,090 | $3,019 – $3,134 |
| Nebraska | 16 | $10,760 | $2,773 | $2,706 – $2,901 |
| Nevada | 9 | $21,238 | $2,998 | $2,998 – $2,998 |
| New Hampshire | 11 | $3,753 | $820 | $760 – $3,087 |
| New Jersey | 34 | $22,621 | $3,415 | $3,204 – $3,664 |
| New Mexico | 10 | $15,844 | $3,029 | $2,804 – $3,260 |
| New York | 91 | $16,554 | $3,023 | $853 – $3,664 |
| North Carolina | 58 | $20,537 | $2,589 | $1,610 – $2,940 |
| North Dakota | 6 | $11,443 | $3,091 | $3,019 – $3,233 |
| Ohio | 83 | $22,372 | $2,540 | $1,495 – $2,879 |
| Oklahoma | 32 | $23,979 | $2,708 | $2,664 – $2,828 |
| Oregon | 22 | $16,941 | $3,354 | $3,176 – $3,518 |
| Pennsylvania | 88 | $25,064 | $2,973 | $2,733 – $3,244 |
| Rhode Island | 6 | $10,637 | $3,267 | $3,267 – $3,267 |
| South Carolina | 27 | $29,363 | $2,663 | $2,520 – $2,778 |
| South Dakota | 13 | $16,070 | $2,990 | $2,893 – $3,019 |
| Tennessee | 38 | $19,965 | $2,594 | $2,409 – $2,774 |
| Texas | 135 | $27,897 | $2,859 | $2,591 – $2,985 |
| Utah | 26 | $11,295 | $2,875 | $2,700 – $3,089 |
| Vermont | 4 | $9,046 | $1,800 | $1,524 – $2,260 |
| Virginia | 39 | $24,964 | $2,527 | $1,902 – $2,992 |
| Washington | 35 | $19,161 | $3,182 | $2,767 – $3,461 |
| West Virginia | 17 | $25,500 | $2,682 | $2,672 – $2,694 |
| Wisconsin | 48 | $16,826 | $2,972 | $2,798 – $3,054 |
| Wyoming | 8 | – | – | – – – |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Mary Hitchcock Mem HospitalLebanon, NH | 459 | $3,452 | $760 |
| Univ of Michigan HospitalsAnn Arbor, MI | 160 | $21,459 | $2,945 |
| Boston Medical Center CorporationBoston, MA | 151 | $4,088 | $1,763 |
| Lemuel Shattuck HospitalBoston, MA | 145 | $11,472 | $3,458 |
| Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica, CA | 129 | $13,576 | $3,958 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 123 | $21,178 | $3,297 |
| Univ of Tx M D Anderson CtrHouston, TX | 120 | $19,026 | $2,879 |
| Stanford HospitalPalo Alto, CA | 118 | $63,271 | $3,573 |
| Erie County Medical CenterBuffalo, NY | 117 | $9,771 | $3,334 |
| Carle Foundation HospitalUrbana, IL | 113 | $4,511 | $658 |
| University of Mississippi Med CenterJackson, MS | 111 | $4,132 | $583 |
| Massachusetts Eye and Ear InfirmaryBoston, MA | 105 | $8,920 | $3,432 |
| Metrohealth SystemCleveland, OH | 94 | $15,414 | $2,257 |
| Hospital of the Univ of PaPhiladelphia, PA | 91 | $16,151 | $2,923 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | 77 | $14,937 | $3,019 |
Questions
How much does level 4 ent procedures cost in the U.S.?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 1,796 hospitals in the U.S. was billed at $20,680 on average, while the average medicare-allowed amount was $2,798, of which Medicare paid $2,217. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 4 ent procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($3,847), Connecticut ($3,564), Alaska ($3,559) and lowest in New Hampshire ($820), Mississippi ($878), Vermont ($1,800).
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 the U.S., average charges were 7.4 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.