Level 4 ENT Procedures in Massachusetts
What 46 hospitals in Massachusetts charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$10,383
Hospital list price billed
Average allowed
$3,020
Medicare's payment + patient's share
Medicare paid
$2,396
Average per service
State rank
#33 of 48
1 = lowest average payment
Hospitals in Massachusetts billed an average of $10,383 for level 4 ent procedures, about 3.4 times the average medicare-allowed amount of $3,020. That payment is 8% 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 $3,020Billed $10,383
About 29¢ was paid for every $1 hospitals in Massachusetts billed for this service.
Massachusetts hospitals: level 4 ent procedures
Every Massachusetts hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Massachusetts
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
| Boston Medical Center CorporationBoston, MA | $1,763 |
|---|---|
| Tufts Medical CenterBoston, MA | $3,088 |
| Emerson HospitalConcord, MA | $3,228 |
| Brigham and Women's HosptialBoston, MA | $3,246 |
| Lahey Clinic HospitalBurlington, MA | $3,350 |
Highest
| St Vincent HospitalWorcester, MA | $3,458 |
|---|---|
| Lemuel Shattuck HospitalBoston, MA | $3,458 |
| Umass Memorial Medical Center INCWorcester, MA | $3,458 |
| Heywood HospitalGardner, MA | $3,458 |
| Lowell General HospitalLowell, MA | $3,458 |
Level 4 ENT Procedures in other states
Questions
How much does level 4 ent procedures cost in Massachusetts?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 46 hospitals in Massachusetts was billed at $10,383 on average, while the average medicare-allowed amount was $3,020, of which Medicare paid $2,396. 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 Massachusetts, average charges were 3.4 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.