facebook tracking Level 2 Upper GI Procedures cost in Idaho: 14 hospitals compared (APC 5302)

Level 2 Upper GI Procedures in Idaho

What 14 hospitals in Idaho charged and were paid for level 2 upper gi procedures (APC 5302), from 2024 Medicare claims.

APC 5302 Outpatient 2024 Medicare data
Average charge $8,276 Hospital list price billed
Average allowed $1,765 Medicare's payment + patient's share
Medicare paid $1,407 Average per service
State rank #28 of 49 1 = lowest average payment

Hospitals in Idaho billed an average of $8,276 for level 2 upper gi procedures, about 4.7 times the average medicare-allowed amount of $1,765. That payment is 3% below the U.S. average of $1,815.

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 $1,765Billed $8,276

About 21¢ was paid for every $1 hospitals in Idaho billed for this service.

Idaho hospitals: level 2 upper 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 373 $6,080 $1,765 $1,401
St Lukes Magic Valley RMCTwin Falls 286 $9,952 $1,829 $1,472
St Lukes Regional Medical CenterBoise 236 $9,809 $1,701 $1,354
Northwest Specialty HospitalPost Falls 138 $7,362 $1,723 $1,375
St Alphonsus Regional Medical CenterBoise 123 $7,656 $1,830 $1,452
Mountain View HospitalIdaho Falls 73 $5,718 $1,675 $1,327
St Luke's Nampa Medical CenterNampa 60 $7,767 $1,712 $1,366
St Joseph Regional Medical CenterLewiston 56 $10,407 $1,834 $1,459
Portneuf Medical CenterPocatello 25 $14,395 $1,834 $1,464
Idaho Falls Community Hospital, LLCIdaho Falls 23 $7,647 $1,712 $1,368
Saint Alphonsus Medical Center - NampaNampa 14 $7,122 $1,842 $1,474
Eastern Idaho Regional Medical CenterIdaho Falls 14 $19,441 $1,712 $1,370
West Valley Medical CenterCaldwell – – – –
Madison Memorial HospitalRexburg – – – –
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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.

Level 2 Upper GI Procedures in other states

Questions

How much does level 2 upper gi procedures cost in Idaho?

In 2024 Medicare data, level 2 upper gi procedures (APC 5302) at 14 hospitals in Idaho was billed at $8,276 on average, while the average medicare-allowed amount was $1,765, of which Medicare paid $1,407. 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 4.7 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.