facebook tracking Level 2 Breast/Lymphatic Surgery and Related Procedures cost in Idaho: 15 hospitals compared (APC 5092)

Level 2 Breast/Lymphatic Surgery and Related Procedures in Idaho

What 15 hospitals in Idaho charged and were paid for level 2 breast/lymphatic surgery and related procedures (APC 5092), from 2024 Medicare claims.

APC 5092 Outpatient 2024 Medicare data
Average charge $37,467 Hospital list price billed
Average allowed $6,081 Medicare's payment + patient's share
Medicare paid $4,840 Average per service
State rank #28 of 49 1 = lowest average payment

Hospitals in Idaho billed an average of $37,467 for level 2 breast/lymphatic surgery and related procedures, about 6.2 times the average medicare-allowed amount of $6,081. That payment is 3% below the U.S. average of $6,262.

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 $6,081Billed $37,467

About 16¢ was paid for every $1 hospitals in Idaho billed for this service.

Idaho hospitals: level 2 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 52 $39,923 $5,868 $4,676
St Alphonsus Regional Medical CenterBoise 40 $23,691 $6,312 $5,029
Portneuf Medical CenterPocatello 40 $63,019 $6,285 $5,003
Kootenai Medical CenterCoeur D'alene 28 $25,223 $6,197 $4,936
Mountain View HospitalIdaho Falls 26 $18,186 $5,868 $4,676
Eastern Idaho Regional Medical CenterIdaho Falls 25 $49,849 $5,868 $4,676
St Lukes Magic Valley RMCTwin Falls 24 $32,225 $6,076 $4,799
St Joseph Regional Medical CenterLewiston 19 $45,847 $6,285 $5,008
Treasure Valley HospitalBoise 12 $29,344 $5,868 $4,676
Saint Alphonsus Medical Center - NampaNampa – – – –
West Valley Medical CenterCaldwell – – – –
Madison Memorial HospitalRexburg – – – –
Northwest Specialty HospitalPost Falls – – – –
St Luke's Nampa Medical CenterNampa – – – –
Idaho Falls Community Hospital, LLCIdaho Falls – – – –
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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$5,868
Eastern Idaho Regional Medical CenterIdaho Falls, ID$5,868
Treasure Valley HospitalBoise, ID$5,868
Mountain View HospitalIdaho Falls, ID$5,868
St Lukes Magic Valley RMCTwin Falls, ID$6,076

Highest

St Alphonsus Regional Medical CenterBoise, ID$6,312
Portneuf Medical CenterPocatello, ID$6,285
St Joseph Regional Medical CenterLewiston, ID$6,285
Kootenai Medical CenterCoeur D'alene, ID$6,197
St Lukes Magic Valley RMCTwin Falls, ID$6,076

Level 2 Breast/Lymphatic Surgery and Related Procedures in other states

Questions

How much does level 2 breast/lymphatic surgery and related procedures cost in Idaho?

In 2024 Medicare data, level 2 breast/lymphatic surgery and related procedures (APC 5092) at 15 hospitals in Idaho was billed at $37,467 on average, while the average medicare-allowed amount was $6,081, of which Medicare paid $4,840. 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 6.2 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.