Level 3 Extraocular, Repair, and Plastic Eye Procedures in Idaho
What 4 hospitals in Idaho charged and were paid for level 3 extraocular, repair, and plastic eye procedures (APC 5503), from 2024 Medicare claims.
Average charge
$7,609
Hospital list price billed
Average allowed
$2,081
Medicare's payment + patient's share
Medicare paid
$1,652
Average per service
State rank
#21 of 45
1 = lowest average payment
Hospitals in Idaho billed an average of $7,609 for level 3 extraocular, repair, and plastic eye procedures, about 3.7 times the average medicare-allowed amount of $2,081. That payment is 7% below the U.S. average of $2,242.
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 $2,081Billed $7,609
About 27¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 3 extraocular, repair, and plastic eye 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 |
|---|---|---|---|---|
| Mountain View HospitalIdaho Falls | 50 | $5,344 | $2,069 | $1,641 |
| St Lukes Regional Medical CenterBoise | 25 | $12,139 | $2,103 | $1,674 |
| West Valley Medical CenterCaldwell | – | – | – | – |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
Level 3 Extraocular, Repair, and Plastic Eye Procedures in other states
Questions
How much does level 3 extraocular, repair, and plastic eye procedures cost in Idaho?
In 2024 Medicare data, level 3 extraocular, repair, and plastic eye procedures (APC 5503) at 4 hospitals in Idaho was billed at $7,609 on average, while the average medicare-allowed amount was $2,081, of which Medicare paid $1,652. 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 3.7 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.