Level 5 ENT Procedures in Wisconsin
What 45 hospitals in Wisconsin charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.
Average charge
$32,266
Hospital list price billed
Average allowed
$5,396
Medicare's payment + patient's share
Medicare paid
$4,286
Average per service
State rank
#28 of 49
1 = lowest average payment
Hospitals in Wisconsin billed an average of $32,266 for level 5 ent procedures, about 6.0 times the average medicare-allowed amount of $5,396. That payment is 3% 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 $5,396Billed $32,266
About 17¢ was paid for every $1 hospitals in Wisconsin billed for this service.
Wisconsin hospitals: level 5 ent procedures
Every Wisconsin hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 212 | $32,670 | $5,405 | $4,290 |
| Froedtert Mem Lutheran HsptlMilwaukee | 99 | $48,676 | $5,466 | $4,346 |
| Luther Hospital Mayo Health SystemEau Claire | 49 | $23,660 | $5,556 | $4,425 |
| Gundersen Luth Med CtrLa Crosse | 44 | $34,077 | $5,517 | $4,389 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 43 | $24,103 | $5,415 | $4,294 |
| Aurora St Lukes Medical CenterMilwaukee | 38 | $38,161 | $5,383 | $4,262 |
| Meriter HsptlMadison | 32 | $30,730 | $5,467 | $4,355 |
| St Mary's HospitalMadison | 31 | $27,585 | $5,332 | $4,215 |
| Aurora Medical CenterGrafton | 31 | $27,259 | $5,328 | $4,244 |
| Appleton Med CtrAppleton | 28 | $17,055 | $4,978 | $3,894 |
| Waukesha Memorial HospitalWaukesha | 24 | $51,974 | $5,335 | $4,251 |
| Aspirus Wausau HospitalWausau | 21 | $25,346 | $5,115 | $4,076 |
| Marshfield Medical CenterMarshfield | 17 | $17,690 | $5,612 | $4,471 |
| Aurora West Allis Medical CenterWest Allis | 17 | $30,591 | $5,335 | $4,251 |
| Aurora Baycare Med CtrGreen Bay | 16 | $25,382 | $5,273 | $4,201 |
| Beloit Mem HsptlBeloit | 14 | $5,884 | $5,696 | $4,532 |
| St Vincent HsptlGreen Bay | 13 | $35,065 | $5,273 | $4,201 |
| Bellin Memorial HsptlGreen Bay | 12 | $26,078 | $4,978 | $3,966 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | – | – | – | – |
| St Elizabeth HsptlAppleton | – | – | – | – |
| Sacred Heart HospitalEau Claire | – | – | – | – |
| Aspirus Rhinelander HospitalRhinelander | – | – | – | – |
| Froedtert SouthKenosha | – | – | – | – |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | – | – | – | – |
| Aurora Sheboygan Mem Med CtrSheboygan | – | – | – | – |
| Aurora Med Center-Washington CountyHartford | – | – | – | – |
| St Nicholas HospitalSheboygan | – | – | – | – |
| Thedacare Regional Med Ctr - NeenahNeenah | – | – | – | – |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | – | – | – | – |
| St Clare Hsptl Hlth SvcsBaraboo | – | – | – | – |
| Aurora Memorial Hsptl BurlingtonBurlington | – | – | – | – |
| St Josephs Com Hsptl West BendWest Bend | – | – | – | – |
| Mercy Hlth Sys CorpJanesville | – | – | – | – |
| Fort HealthcareFort Atkinson | – | – | – | – |
| Wheaton Franciscan Healthcare- St FrancisMilwaukee | – | – | – | – |
| Aurora Lakeland Med CtrElkhorn | – | – | – | – |
| Community Mem HsptlMenomonee Falls | – | – | – | – |
| Bay Area Med CtrMarinette | – | – | – | – |
| Ascension SE Wisconsin HospitalMilwaukee | – | – | – | – |
| Aurora Med Ctr KenoshaKenosha | – | – | – | – |
| Oakleaf Surgical HospitalEau Claire | – | – | – | – |
| Aurora Med Ctr OshkoshOshkosh | – | – | – | – |
| St Clare's Hospital of Weston INCWeston | – | – | – | – |
| Aurora Medical CenterSummit | – | – | – | – |
| Marshfield Medical Center - Eau ClaireEau Claire | – | – | – | – |
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
| Appleton Med CtrAppleton, WI | $4,978 |
|---|---|
| Bellin Memorial HsptlGreen Bay, WI | $4,978 |
| Aspirus Wausau HospitalWausau, WI | $5,115 |
| St Vincent HsptlGreen Bay, WI | $5,273 |
| Aurora Baycare Med CtrGreen Bay, WI | $5,273 |
Highest
| Beloit Mem HsptlBeloit, WI | $5,696 |
|---|---|
| Marshfield Medical CenterMarshfield, WI | $5,612 |
| Luther Hospital Mayo Health SystemEau Claire, WI | $5,556 |
| Gundersen Luth Med CtrLa Crosse, WI | $5,517 |
| Meriter HsptlMadison, WI | $5,467 |
Level 5 ENT Procedures in other states
Questions
How much does level 5 ent procedures cost in Wisconsin?
In 2024 Medicare data, level 5 ent procedures (APC 5165) at 45 hospitals in Wisconsin was billed at $32,266 on average, while the average medicare-allowed amount was $5,396, of which Medicare paid $4,286. 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 6.0 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.