Level 4 ENT Procedures in North Dakota
What 6 hospitals in North Dakota charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$11,443
Hospital list price billed
Average allowed
$3,091
Medicare's payment + patient's share
Medicare paid
$2,463
Average per service
State rank
#39 of 48
1 = lowest average payment
Hospitals in North Dakota billed an average of $11,443 for level 4 ent procedures, about 3.7 times the average medicare-allowed amount of $3,091. That payment is 10% 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 $3,091Billed $11,443
About 27¢ was paid for every $1 hospitals in North Dakota billed for this service.
North Dakota hospitals: level 4 ent procedures
Every North Dakota hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Sanford Medical Center FargoFargo | 18 | $12,166 | $3,019 | $2,405 |
| Altru Health SystemGrand Forks | 17 | $12,966 | $3,233 | $2,575 |
| Essentia Health-FargoFargo | 15 | $8,849 | $3,019 | $2,405 |
| St Alexius Medical CenterBismarck | – | – | – | – |
| Trinity HospitalsMinot | – | – | – | – |
| Sanford Medical Center BismarckBismarck | – | – | – | – |
Lowest and highest allowed amounts in North Dakota
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
| Sanford Medical Center FargoFargo, ND | $3,019 |
|---|---|
| Essentia Health-FargoFargo, ND | $3,019 |
| Altru Health SystemGrand Forks, ND | $3,233 |
Highest
| Altru Health SystemGrand Forks, ND | $3,233 |
|---|---|
| Sanford Medical Center FargoFargo, ND | $3,019 |
| Essentia Health-FargoFargo, ND | $3,019 |
Level 4 ENT Procedures in other states
Questions
How much does level 4 ent procedures cost in North Dakota?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 6 hospitals in North Dakota was billed at $11,443 on average, while the average medicare-allowed amount was $3,091, of which Medicare paid $2,463. 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 North Dakota, average charges were 3.7 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.