Level 5 ENT Procedures in Maine
What 13 hospitals in Maine charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.
Average charge
$28,094
Hospital list price billed
Average allowed
$5,319
Medicare's payment + patient's share
Medicare paid
$4,221
Average per service
State rank
#27 of 49
1 = lowest average payment
Hospitals in Maine billed an average of $28,094 for level 5 ent procedures, about 5.3 times the average medicare-allowed amount of $5,319. 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 $5,319Billed $28,094
About 19¢ was paid for every $1 hospitals in Maine billed for this service.
Maine hospitals: level 5 ent procedures
Every Maine hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Maine Medical CenterPortland | 110 | $28,996 | $5,383 | $4,264 |
| St Joseph HospitalBangor | 23 | $22,466 | $5,025 | $4,004 |
| York HospitalYork | 12 | $26,740 | $5,502 | $4,384 |
| Eastern Maine Medical CenterBangor | 11 | $32,319 | $5,102 | $4,065 |
| Mercy HospitalPortland | – | – | – | – |
| Northern Light a R Gould HospitalPresque Isle | – | – | – | – |
| Southern Maine Health CareBiddeford | – | – | – | – |
| Mid Coast HospitalBrunswick | – | – | – | – |
| Central Maine Medical CenterLewiston | – | – | – | – |
| Cary Medical CenterCaribou | – | – | – | – |
| Maine General Medical CenterWaterville | – | – | – | – |
| Maine Coast Memorial HospitalEllsworth | – | – | – | – |
| Penobscot Bay Medical CenterRockport | – | – | – | – |
Lowest and highest allowed amounts in Maine
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
| St Joseph HospitalBangor, ME | $5,025 |
|---|---|
| Eastern Maine Medical CenterBangor, ME | $5,102 |
| Maine Medical CenterPortland, ME | $5,383 |
| York HospitalYork, ME | $5,502 |
Highest
| York HospitalYork, ME | $5,502 |
|---|---|
| Maine Medical CenterPortland, ME | $5,383 |
| Eastern Maine Medical CenterBangor, ME | $5,102 |
| St Joseph HospitalBangor, ME | $5,025 |
Level 5 ENT Procedures in other states
Questions
How much does level 5 ent procedures cost in Maine?
In 2024 Medicare data, level 5 ent procedures (APC 5165) at 13 hospitals in Maine was billed at $28,094 on average, while the average medicare-allowed amount was $5,319, of which Medicare paid $4,221. 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 Maine, average charges were 5.3 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.