facebook tracking Level 4 ENT Procedures cost in Iowa: 24 hospitals compared (APC 5164)

Level 4 ENT Procedures in Iowa

What 24 hospitals in Iowa charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.

APC 5164 Outpatient 2024 Medicare data
Average charge $12,758 Hospital list price billed
Average allowed $2,761 Medicare's payment + patient's share
Medicare paid $2,195 Average per service
State rank #19 of 48 1 = lowest average payment

Hospitals in Iowa billed an average of $12,758 for level 4 ent procedures, about 4.6 times the average medicare-allowed amount of $2,761. That payment is 1% below 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 $2,761Billed $12,758

About 22¢ was paid for every $1 hospitals in Iowa billed for this service.

Iowa hospitals: level 4 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Broadlawns Medical CenterDes Moines 62 $5,199 $2,763 $2,197
University of Iowa Hospital & ClinicsIowa City 46 $17,847 $2,574 $2,041
Southeast Iowa Regional Medical CenterWest Burlington 20 $13,530 $2,974 $2,369
Spencer Municipal HospitalSpencer 18 $9,146 $2,754 $2,191
St Lukes HospitalCedar Rapids 17 $12,888 $2,777 $2,198
The Finley HospitalDubuque 15 $14,088 $2,754 $2,194
Mercy Medical Center-Des MoinesDes Moines 14 $18,132 $2,754 $2,194
Mercy Medical Center-North IowaMason City 12 $28,325 $3,121 $2,486
Marshalltown Medical & Surgical CenterMarshalltown – – – –
St Anthony Regional Hospital & Nursing HomeCarroll – – – –
Trinity Regional Medical CenterFort Dodge – – – –
Mary Greeley Medical CenterAmes – – – –
Mercyone Newton Medical CenterNewton – – – –
Genesis Medical Center-DavenportDavenport – – – –
Jennie Edmundson HospitalCouncil Bluffs – – – –
Mercyone Waterloo Medical CenterWaterloo – – – –
Mercy Medical Center-DubuqueDubuque – – – –
Mercy Medical Center - Cedar RapidsCedar Rapids – – – –
Mercy Medical Center-ClintonClinton – – – –
Iowa Methodist Medical CenterDes Moines – – – –
Ottumwa Regional Health CenterOttumwa – – – –
Trinity Medical CenterDavenport – – – –
Allen Memorial HospitalWaterloo – – – –
Grinnell Regional Medical CenterGrinnell – – – –
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Lowest and highest allowed amounts in Iowa

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

University of Iowa Hospital & ClinicsIowa City, IA$2,574
Mercy Medical Center-Des MoinesDes Moines, IA$2,754
The Finley HospitalDubuque, IA$2,754
Spencer Municipal HospitalSpencer, IA$2,754
Broadlawns Medical CenterDes Moines, IA$2,763

Highest

Mercy Medical Center-North IowaMason City, IA$3,121
Southeast Iowa Regional Medical CenterWest Burlington, IA$2,974
St Lukes HospitalCedar Rapids, IA$2,777
Broadlawns Medical CenterDes Moines, IA$2,763
Spencer Municipal HospitalSpencer, IA$2,754

Level 4 ENT Procedures in other states

Questions

How much does level 4 ent procedures cost in Iowa?

In 2024 Medicare data, level 4 ent procedures (APC 5164) at 24 hospitals in Iowa was billed at $12,758 on average, while the average medicare-allowed amount was $2,761, of which Medicare paid $2,195. 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 Iowa, average charges were 4.6 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.