Level 4 ENT Procedures in Wisconsin
What 48 hospitals in Wisconsin charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$16,826
Hospital list price billed
Average allowed
$2,972
Medicare's payment + patient's share
Medicare paid
$2,362
Average per service
State rank
#29 of 48
1 = lowest average payment
Hospitals in Wisconsin billed an average of $16,826 for level 4 ent procedures, about 5.7 times the average medicare-allowed amount of $2,972. 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 $2,972Billed $16,826
About 18¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 4 ent procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Wisconsin
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
| Marshfield Medical Center - Eau ClaireEau Claire, WI | $2,798 |
|---|---|
| Bellin Memorial HsptlGreen Bay, WI | $2,881 |
| Meriter HsptlMadison, WI | $2,936 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $3,006 |
| Froedtert Mem Lutheran HsptlMilwaukee, WI | $3,030 |
Highest
| Luther Hospital Mayo Health SystemEau Claire, WI | $3,054 |
|---|---|
| Gundersen Luth Med CtrLa Crosse, WI | $3,033 |
| Froedtert Mem Lutheran HsptlMilwaukee, WI | $3,030 |
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $3,006 |
| Meriter HsptlMadison, WI | $2,936 |
Level 4 ENT Procedures in other states
Questions
How much does level 4 ent procedures cost in Wisconsin?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 48 hospitals in Wisconsin was billed at $16,826 on average, while the average medicare-allowed amount was $2,972, of which Medicare paid $2,362. 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 Wisconsin, average charges were 5.7 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.