Level 5 ENT Procedures in West Virginia
What 15 hospitals in West Virginia charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.
Average charge
$32,262
Hospital list price billed
Average allowed
$4,942
Medicare's payment + patient's share
Medicare paid
$3,930
Average per service
State rank
#8 of 49
1 = lowest average payment
Hospitals in West Virginia billed an average of $32,262 for level 5 ent procedures, about 6.5 times the average medicare-allowed amount of $4,942. That payment is 12% 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 $4,942Billed $32,262
About 15¢ was paid for every $1 hospitals in West Virginia billed for this service.
West Virginia hospitals: level 5 ent procedures
Every West Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| West Virginia University HospitalsMorgantown | 92 | $39,121 | $4,857 | $3,859 |
| Charleston Area Medical CenterCharleston | 34 | $33,203 | $4,673 | $3,710 |
| St Mary's Medical CenterHuntington | 19 | $22,400 | $4,988 | $3,974 |
| United Hospital CenterBridgeport | 17 | $22,768 | $5,594 | $4,457 |
| Berkeley Medical CenterMartinsburg | 11 | $30,457 | $5,377 | $4,284 |
| Camc Charleston Surgical HospitalCharleston | 11 | $5,493 | $4,964 | $3,955 |
| Greenbrier Valley Medical CenterRonceverte | – | – | – | – |
| Rivers HealthPoint Pleasant | – | – | – | – |
| Weirton Medical CenterWeirton | – | – | – | – |
| Thomas Memorial HospitalSouth Charleston | – | – | – | – |
| Princeton Community HospitalPrinceton | – | – | – | – |
| Logan Regional Medical CenterLogan | – | – | – | – |
| Wheeling HospitalWheeling | – | – | – | – |
| Cabell-Huntington Hospital INCHuntington | – | – | – | – |
| Beckley Arh HospitalBeckley | – | – | – | – |
Lowest and highest allowed amounts in West Virginia
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
| Charleston Area Medical CenterCharleston, WV | $4,673 |
|---|---|
| West Virginia University HospitalsMorgantown, WV | $4,857 |
| Camc Charleston Surgical HospitalCharleston, WV | $4,964 |
| St Mary's Medical CenterHuntington, WV | $4,988 |
| Berkeley Medical CenterMartinsburg, WV | $5,377 |
Highest
| United Hospital CenterBridgeport, WV | $5,594 |
|---|---|
| Berkeley Medical CenterMartinsburg, WV | $5,377 |
| St Mary's Medical CenterHuntington, WV | $4,988 |
| Camc Charleston Surgical HospitalCharleston, WV | $4,964 |
| West Virginia University HospitalsMorgantown, WV | $4,857 |
Level 5 ENT Procedures in other states
Questions
How much does level 5 ent procedures cost in West Virginia?
In 2024 Medicare data, level 5 ent procedures (APC 5165) at 15 hospitals in West Virginia was billed at $32,262 on average, while the average medicare-allowed amount was $4,942, of which Medicare paid $3,930. 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 West Virginia, average charges were 6.5 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.