facebook tracking Level 4 ENT Procedures cost in Pennsylvania: 88 hospitals compared (APC 5164)

Level 4 ENT Procedures in Pennsylvania

What 88 hospitals in Pennsylvania charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.

APC 5164 Outpatient 2024 Medicare data
Average charge $25,064 Hospital list price billed
Average allowed $2,973 Medicare's payment + patient's share
Medicare paid $2,356 Average per service
State rank #30 of 48 1 = lowest average payment

Hospitals in Pennsylvania billed an average of $25,064 for level 4 ent procedures, about 8.4 times the average medicare-allowed amount of $2,973. That payment is 6% 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 $2,973Billed $25,064

About 12¢ was paid for every $1 hospitals in Pennsylvania billed for this service.

Pennsylvania hospitals: level 4 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Hospital of the Univ of PaPhiladelphia 91 $16,151 $2,923 $2,326
Thomas Jefferson University HospitalPhiladelphia 56 $24,619 $3,027 $2,399
Lehigh Valley HospitalAllentown 30 $23,137 $3,140 $2,502
St Luke's Hospital BethlehemBethlehem 27 $49,581 $3,048 $2,404
Geisinger Medical CenterDanville 24 $37,327 $2,876 $2,283
Geisinger Wyoming Vly Med CtrWilkes-Barre 23 $27,508 $2,776 $2,192
Chambersburg HospitalChambersburg 22 $18,697 $3,097 $2,417
Crozer Chester Medical CenterChester 17 $15,997 $3,128 $2,492
Lehigh Valley Hospital - Dickson CityDickson City 16 $21,898 $2,733 $2,144
Dubois Regional Medical CenterDubois 15 $7,277 $2,916 $2,290
UPMC Presbyterian ShadysidePittsburgh 14 $51,533 $2,876 $2,291
Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia 12 $22,227 $3,244 $2,584
Milton S Hershey Medical CenterHershey 11 $39,294 $2,865 $2,283
Holy Spirit HospitalCamp Hill – – – –
Saint Vincent Health CenterErie – – – –
Evangelical Community HospitalLewisburg – – – –
Temple University HospitalPhiladelphia – – – –
UPMC MercyPittsburgh – – – –
Schuylkill Medical Center - South Jackson StreetPottsville – – – –
St Luke's Quakertown HospitalQuakertown – – – –
Heritage Valley SewickleySewickley – – – –
Uniontown HospitalUniontown – – – –
Washington Hospital, theWashington – – – –
Reading Hospital and Med CtrWest Reading – – – –
Williamsport Hospital & Medical CenterWilliamsport – – – –
York HospitalYork – – – –
Lewistown HospitalLewistown – – – –
Allegheny General HospitalPittsburgh – – – –
Penn Highlands HuntingdonHuntingdon – – – –
Grand View HospitalSellersville – – – –
Carlisle Regional Medical CtrCarlisle – – – –
Nason HospitalRoaring Spring – – – –
Hamot Medical CenterErie – – – –
UPMC Pinnacle HospitalsHarrisburg – – – –
Altoona Regional Health SystemAltoona – – – –
Robert Packer HospitalSayre – – – –
West Penn HospitalPittsburgh – – – –
Northwest Medical CenterOil City – – – –
Holy Redeemer Hosp and Med CtrJenkintown – – – –
Lancaster General HospitalLancaster – – – –
UPMC MemorialYork – – – –
UPMC St MargaretPittsburgh – – – –
UPMC PassavantPittsburgh – – – –
Meadville Medical CenterMeadville – – – –
Jefferson Health- NortheastPhiladelphia – – – –
UPMC BedfordEverett – – – –
Pottstown Memorial Med CenterPottstown – – – –
Wayne Memorial HospitalHonesdale – – – –
Phoenixville HospitalPhoenixville – – – –
Wilkes-Barre General HospitalWilkes-Barre – – – –
Main Line Hospital Bryn Mawr CampusBryn Mawr – – – –
Albert Einstein Medical CenterPhiladelphia – – – –
Main Line Hospital PaoliPaoli – – – –
Mercy Health SystemConshohocken – – – –
ACMH HospitalKittanning – – – –
Butler Health SystemButler – – – –
Chester County HospitalWest Chester – – – –
Highlands HospitalConnellsville – – – –
Hazleton General HospitalHazleton – – – –
Main Line Hospital LankenauWynnewood – – – –
Fox Chase Cancer CenterPhiladelphia – – – –
Millcreek Community HospitalErie – – – –
Punxsutawney Area HospitalPunxsutawney – – – –
Pocono Medical CenterEast Stroudsburg – – – –
Doylestown HospitalDoylestown – – – –
Sharon Regional Health SystemSharon – – – –
Latrobe Area HospitalLatrobe – – – –
Riddle Memorial HospitalMedia – – – –
Penn Presbyterian Medical CenterPhiladelphia – – – –
Ephrata Community HospitalEphrata – – – –
St Clair Memorial HospitalPittsburgh – – – –
Abington Memorial HospitalAbington – – – –
Hanover HospitalHanover – – – –
Mercy Hospital ScrantonScranton – – – –
Jefferson Regional Medical CenterClairton – – – –
Western Pennsylvania Hosp Forbes Regional CampusMonroeville – – – –
Mount Nittany Medical CenterState College – – – –
Surgical Institute of ReadingWyomissing – – – –
Physicians Care Surgical HospitalRoyersford – – – –
St Luke's Hospital - Anderson CampusEaston – – – –
UPMC EastMonroeville – – – –
Jefferson Einstein Montgomery HospitalEast Norriton – – – –
St Luke's Hospital - Monroe CampusStroudsburg – – – –
Wills Eye HospitalPhiladelphia – – – –
Geisinger St. Luke's HospitalOrwigsburg – – – –
St Luke's Hospital - Carbon CampusLehighton – – – –
Penn State Health Lancaster Medical CenterLancaster – – – –
Children's Hospital of PhiladelphiaPhiladelphia – – – –
Level 4 ENT Procedures: all states All Pennsylvania hospitals Pennsylvania hospital finances
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Lowest and highest allowed amounts in Pennsylvania

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

Lehigh Valley Hospital - Dickson CityDickson City, PA$2,733
Geisinger Wyoming Vly Med CtrWilkes-Barre, PA$2,776
Milton S Hershey Medical CenterHershey, PA$2,865
UPMC Presbyterian ShadysidePittsburgh, PA$2,876
Geisinger Medical CenterDanville, PA$2,876

Highest

Pennsylvania Hosp of the Univ of Pa Health SysPhiladelphia, PA$3,244
Lehigh Valley HospitalAllentown, PA$3,140
Crozer Chester Medical CenterChester, PA$3,128
Chambersburg HospitalChambersburg, PA$3,097
St Luke's Hospital BethlehemBethlehem, PA$3,048

Level 4 ENT Procedures in other states

Colorado · $3,065 Massachusetts · $3,020 Minnesota · $2,893 Nevada · $2,998 New Mexico · $3,029 New York · $3,023 South Dakota · $2,990 Wisconsin · $2,972

Questions

How much does level 4 ent procedures cost in Pennsylvania?

In 2024 Medicare data, level 4 ent procedures (APC 5164) at 88 hospitals in Pennsylvania was billed at $25,064 on average, while the average medicare-allowed amount was $2,973, of which Medicare paid $2,356. 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 Pennsylvania, average charges were 8.4 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.