Level 1 Breast/Lymphatic Surgery and Related Procedures in Idaho
What 15 hospitals in Idaho charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$21,662
Hospital list price billed
Average allowed
$3,536
Medicare's payment + patient's share
Medicare paid
$2,812
Average per service
State rank
#28 of 49
1 = lowest average payment
Hospitals in Idaho billed an average of $21,662 for level 1 breast/lymphatic surgery and related procedures, about 6.1 times the average medicare-allowed amount of $3,536. That payment is 4% below the U.S. average of $3,688.
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 $3,536Billed $21,662
About 16¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 1 breast/lymphatic surgery and related 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 |
|---|---|---|---|---|
| St Lukes Regional Medical CenterBoise | 71 | $20,836 | $3,392 | $2,695 |
| St Alphonsus Regional Medical CenterBoise | 29 | $15,330 | $3,689 | $2,940 |
| Kootenai Medical CenterCoeur D'alene | 24 | $16,612 | $3,623 | $2,875 |
| Portneuf Medical CenterPocatello | 17 | $33,981 | $3,674 | $2,927 |
| St Joseph Regional Medical CenterLewiston | 14 | $29,950 | $3,674 | $2,927 |
| St Lukes Magic Valley RMCTwin Falls | 13 | $16,551 | $3,674 | $2,927 |
| Eastern Idaho Regional Medical CenterIdaho Falls | 12 | $33,622 | $3,430 | $2,733 |
| St Luke's Nampa Medical CenterNampa | 11 | $18,109 | $3,430 | $2,727 |
| Saint Alphonsus Medical Center - NampaNampa | – | – | – | – |
| West Valley Medical CenterCaldwell | – | – | – | – |
| Madison Memorial HospitalRexburg | – | – | – | – |
| Treasure Valley HospitalBoise | – | – | – | – |
| Mountain View HospitalIdaho Falls | – | – | – | – |
| Northwest Specialty HospitalPost Falls | – | – | – | – |
| Idaho Falls Community Hospital, LLCIdaho Falls | – | – | – | – |
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
| St Lukes Regional Medical CenterBoise, ID | $3,392 |
|---|---|
| Eastern Idaho Regional Medical CenterIdaho Falls, ID | $3,430 |
| St Luke's Nampa Medical CenterNampa, ID | $3,430 |
| Kootenai Medical CenterCoeur D'alene, ID | $3,623 |
| St Lukes Magic Valley RMCTwin Falls, ID | $3,674 |
Highest
| St Alphonsus Regional Medical CenterBoise, ID | $3,689 |
|---|---|
| St Lukes Magic Valley RMCTwin Falls, ID | $3,674 |
| St Joseph Regional Medical CenterLewiston, ID | $3,674 |
| Portneuf Medical CenterPocatello, ID | $3,674 |
| Kootenai Medical CenterCoeur D'alene, ID | $3,623 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Idaho?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 15 hospitals in Idaho was billed at $21,662 on average, while the average medicare-allowed amount was $3,536, of which Medicare paid $2,812. 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 6.1 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.