facebook tracking Level 4 ENT Procedures cost in Delaware: 6 hospitals compared (APC 5164)

Level 4 ENT Procedures in Delaware

What 6 hospitals in Delaware charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.

APC 5164 Outpatient 2024 Medicare data
Average charge $13,748 Hospital list price billed
Average allowed $3,230 Medicare's payment + patient's share
Medicare paid $2,574 Average per service
State rank #41 of 48 1 = lowest average payment

Hospitals in Delaware billed an average of $13,748 for level 4 ent procedures, about 4.3 times the average medicare-allowed amount of $3,230. That payment is 15% above the U.S. average 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.

Paid $3,230Billed $13,748

About 23¢ was paid for every $1 hospitals in Delaware billed for this service.

Delaware hospitals: level 4 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Christiana Care Health Services, INC.Newark 14 $13,748 $3,230 $2,574
St Francis HospitalWilmington – – – –
Bayhealth - Kent General HospitalDover – – – –
Nanticoke Memorial HospitalSeaford – – – –
Beebe Medical CenterLewes – – – –
Bayhealth Hospital, Sussex CampusMilford – – – –
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Level 4 ENT Procedures in other states

Questions

How much does level 4 ent procedures cost in Delaware?

In 2024 Medicare data, level 4 ent procedures (APC 5164) at 6 hospitals in Delaware was billed at $13,748 on average, while the average medicare-allowed amount was $3,230, of which Medicare paid $2,574. 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 Delaware, average charges were 4.3 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.