Level 4 ENT Procedures in South Dakota
What 13 hospitals in South Dakota charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$16,070
Hospital list price billed
Average allowed
$2,990
Medicare's payment + patient's share
Medicare paid
$2,380
Average per service
State rank
#31 of 48
1 = lowest average payment
Hospitals in South Dakota billed an average of $16,070 for level 4 ent procedures, about 5.4 times the average medicare-allowed amount of $2,990. That payment is 7% 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 $2,990Billed $16,070
About 19¢ was paid for every $1 hospitals in South Dakota billed for this service.
South Dakota hospitals: level 4 ent procedures
Every South 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 |
|---|---|---|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls | 77 | $14,937 | $3,019 | $2,405 |
| Rapid City Regional HospitalRapid City | 38 | $17,182 | $2,978 | $2,372 |
| Sioux Falls Surgical Hospital LLPSioux Falls | 22 | $25,657 | $2,922 | $2,308 |
| Same Day Surgery Center LLCRapid City | 22 | $15,309 | $3,019 | $2,405 |
| Sanford Usd Medical CenterSioux Falls | 21 | $13,642 | $2,960 | $2,357 |
| Avera St LukesAberdeen | 15 | $11,064 | $3,019 | $2,400 |
| Dunes Surgical HospitalNorth Sioux City | 15 | $20,843 | $3,019 | $2,405 |
| Black Hills Surgical Hospital LLPRapid City | 12 | $8,180 | $2,893 | $2,305 |
| Prairie Lakes Hosp & Care CtrWatertown | – | – | – | – |
| Brookings HospitalBrookings | – | – | – | – |
| Avera Sacred Heart HospitalYankton | – | – | – | – |
| St Mary's Healthcare CenterPierre | – | – | – | – |
| Spearfish Regional HospitalSpearfish | – | – | – | – |
Lowest and highest allowed amounts in South 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
| Black Hills Surgical Hospital LLPRapid City, SD | $2,893 |
|---|---|
| Sioux Falls Surgical Hospital LLPSioux Falls, SD | $2,922 |
| Sanford Usd Medical CenterSioux Falls, SD | $2,960 |
| Rapid City Regional HospitalRapid City, SD | $2,978 |
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $3,019 |
Highest
| Avera St LukesAberdeen, SD | $3,019 |
|---|---|
| Avera McKennan Hospital & University Health CenterSioux Falls, SD | $3,019 |
| Dunes Surgical HospitalNorth Sioux City, SD | $3,019 |
| Same Day Surgery Center LLCRapid City, SD | $3,019 |
| Rapid City Regional HospitalRapid City, SD | $2,978 |
Level 4 ENT Procedures in other states
Questions
How much does level 4 ent procedures cost in South Dakota?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 13 hospitals in South Dakota was billed at $16,070 on average, while the average medicare-allowed amount was $2,990, of which Medicare paid $2,380. 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 South Dakota, average charges were 5.4 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.