facebook tracking Level 5 ENT Procedures cost in Indiana: 49 hospitals compared (APC 5165)

Level 5 ENT Procedures in Indiana

What 49 hospitals in Indiana charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.

APC 5165 Outpatient 2024 Medicare data
Average charge $42,662 Hospital list price billed
Average allowed $5,285 Medicare's payment + patient's share
Medicare paid $4,196 Average per service
State rank #23 of 49 1 = lowest average payment

Hospitals in Indiana billed an average of $42,662 for level 5 ent procedures, about 8.1 times the average medicare-allowed amount of $5,285. That payment is 5% below the U.S. average of $5,586.

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 $5,285Billed $42,662

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

Indiana hospitals: level 5 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Clarian Health PartnersIndianapolis 98 $53,293 $5,162 $4,074
Community HospitalMunster 66 $30,343 $5,441 $4,320
Indiana University Health North HospitalCarmel 49 $48,816 $5,280 $4,205
St Vincent Hospital & Health ServicesIndianapolis 39 $53,496 $5,249 $4,182
Franciscan St Margaret Health - DyerDyer 38 $32,292 $5,392 $4,273
Community Hospital NorthIndianapolis 38 $53,020 $5,179 $4,103
Franciscan Health IndianapolisIndianapolis 32 $42,018 $5,308 $4,223
Deaconess Hospital INCEvansville 28 $37,550 $5,220 $4,159
Memorial Hospital of South BendSouth Bend 26 $22,666 $5,285 $4,211
Reid Hosp & Hlth Care ServicesRichmond 22 $29,870 $5,591 $4,454
Bloomington HospitalBloomington 22 $50,223 $5,289 $4,214
St Mary's Medical Center of Evansville INCEvansville 22 $40,827 $5,220 $4,150
Lutheran Hospital of IndianaFort Wayne 19 $68,744 $5,074 $3,997
Parkview HospitalFort Wayne 19 $61,175 $5,408 $4,309
Elkhart General HospitalElkhart 17 $29,256 $5,408 $4,309
Saint Joseph Reg Medical CtrSouth Bend 16 $37,177 $5,408 $4,309
Memorial Hospital and Health Care CenterJasper 15 $27,544 $4,943 $3,882
St Mary Medical Center INCHobart 14 $25,780 $5,508 $4,388
Indiana University Health Arnett HospitalLafayette 13 $49,872 $5,221 $4,160
Franciscan St Anthony Health - Michigan CityMichigan City 11 $17,600 $5,220 $4,145
Johnson Memorial HospitalFranklin – – – –
Methodist Hospitals, INCGary – – – –
Hendricks Regional HealthDanville – – – –
La Porte Regional Health SystLa Porte – – – –
St Catherine Hospital INCEast Chicago – – – –
Clark Memorial HospitalJeffersonville – – – –
St Joseph Hospital & Health Center INCKokomo – – – –
Marion General HospitalMarion – – – –
Union Hospital INCTerre Haute – – – –
Eskenazi HealthIndianapolis – – – –
IU Health Goshen HospitalGoshen – – – –
Porter, Valparaiso HospitalValparaiso – – – –
Good Samaritan HospitalVincennes – – – –
Riverview HospitalNoblesville – – – –
King's Daughters' Hospital and Health Services,TheMadison – – – –
Memorial HospitalLogansport – – – –
Community Hospital EastIndianapolis – – – –
Dearborn County HospitalLawrenceburg – – – –
Saint John's Health SystemAnderson – – – –
Ball Memorial Hospital INCMuncie – – – –
Major HospitalShelbyville – – – –
Witham Health ServicesLebanon – – – –
Franciscan Health LafayetteLafayette – – – –
Community Hospital of Anderson and Madison CountyAnderson – – – –
Franciscan St Anthony Health - Crown PointCrown Point – – – –
Community Hospital SouthIndianapolis – – – –
Indiana University Health West HospitalAvon – – – –
Pinnacle HospitalCrown Point – – – –
Physicians' Medical Center LLCNew Albany – – – –
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Lowest and highest allowed amounts in Indiana

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

Memorial Hospital and Health Care CenterJasper, IN$4,943
Lutheran Hospital of IndianaFort Wayne, IN$5,074
Clarian Health PartnersIndianapolis, IN$5,162
Community Hospital NorthIndianapolis, IN$5,179
Deaconess Hospital INCEvansville, IN$5,220

Highest

Reid Hosp & Hlth Care ServicesRichmond, IN$5,591
St Mary Medical Center INCHobart, IN$5,508
Community HospitalMunster, IN$5,441
Saint Joseph Reg Medical CtrSouth Bend, IN$5,408
Elkhart General HospitalElkhart, IN$5,408

Level 5 ENT Procedures in other states

Questions

How much does level 5 ent procedures cost in Indiana?

In 2024 Medicare data, level 5 ent procedures (APC 5165) at 49 hospitals in Indiana was billed at $42,662 on average, while the average medicare-allowed amount was $5,285, of which Medicare paid $4,196. 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 Indiana, average charges were 8.1 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.