Complex GI Procedures in Idaho
What 12 hospitals in Idaho charged and were paid for complex gi procedures (APC 5331), from 2024 Medicare claims.
Average charge
$20,294
Hospital list price billed
Average allowed
$5,177
Medicare's payment + patient's share
Medicare paid
$4,116
Average per service
State rank
#28 of 48
1 = lowest average payment
Hospitals in Idaho billed an average of $20,294 for complex gi procedures, about 3.9 times the average medicare-allowed amount of $5,177. That payment is 3% below the U.S. average of $5,364.
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 $5,177Billed $20,294
About 26¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: complex gi procedures
Every Idaho hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Kootenai Medical CenterCoeur D'alene | 47 | $21,421 | $4,979 | $3,947 |
| St Alphonsus Regional Medical CenterBoise | 32 | $17,982 | $5,516 | $4,395 |
| St Lukes Regional Medical CenterBoise | 21 | $24,522 | $5,129 | $4,086 |
| Idaho Falls Community Hospital, LLCIdaho Falls | 12 | $14,648 | $5,129 | $4,086 |
| St Lukes Magic Valley RMCTwin Falls | – | – | – | – |
| St Joseph Regional Medical CenterLewiston | – | – | – | – |
| Saint Alphonsus Medical Center - NampaNampa | – | – | – | – |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
| Portneuf Medical CenterPocatello | – | – | – | – |
| Treasure Valley HospitalBoise | – | – | – | – |
| Northwest Specialty HospitalPost Falls | – | – | – | – |
| St Luke's Nampa Medical CenterNampa | – | – | – | – |
Lowest and highest allowed amounts in Idaho
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
| Kootenai Medical CenterCoeur D'alene, ID | $4,979 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $5,129 |
| Idaho Falls Community Hospital, LLCIdaho Falls, ID | $5,129 |
| St Alphonsus Regional Medical CenterBoise, ID | $5,516 |
Highest
| St Alphonsus Regional Medical CenterBoise, ID | $5,516 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $5,129 |
| Idaho Falls Community Hospital, LLCIdaho Falls, ID | $5,129 |
| Kootenai Medical CenterCoeur D'alene, ID | $4,979 |
Complex GI Procedures in other states
Questions
How much does complex gi procedures cost in Idaho?
In 2024 Medicare data, complex gi procedures (APC 5331) at 12 hospitals in Idaho was billed at $20,294 on average, while the average medicare-allowed amount was $5,177, of which Medicare paid $4,116. 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 Idaho, average charges were 3.9 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.