Level 3 Lower GI Procedures in Idaho
What 13 hospitals in Idaho charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$12,065
Hospital list price billed
Average allowed
$2,530
Medicare's payment + patient's share
Medicare paid
$2,023
Average per service
State rank
#25 of 49
1 = lowest average payment
Hospitals in Idaho billed an average of $12,065 for level 3 lower gi procedures, about 4.8 times the average medicare-allowed amount of $2,530. That payment is 6% below the U.S. average of $2,703.
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 $2,530Billed $12,065
About 21¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 3 lower 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 |
|---|---|---|---|---|
| St Lukes Regional Medical CenterBoise | 36 | $9,792 | $2,527 | $2,017 |
| St Alphonsus Regional Medical CenterBoise | 31 | $14,491 | $2,490 | $1,955 |
| Kootenai Medical CenterCoeur D'alene | 24 | $10,248 | $2,567 | $2,098 |
| Northwest Specialty HospitalPost Falls | 11 | $16,632 | $2,572 | $2,073 |
| St Lukes Magic Valley RMCTwin Falls | – | – | – | – |
| St Joseph Regional Medical CenterLewiston | – | – | – | – |
| Saint Alphonsus Medical Center - NampaNampa | – | – | – | – |
| West Valley Medical CenterCaldwell | – | – | – | – |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
| Madison Memorial HospitalRexburg | – | – | – | – |
| Portneuf Medical CenterPocatello | – | – | – | – |
| Mountain View HospitalIdaho 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 Alphonsus Regional Medical CenterBoise, ID | $2,490 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $2,527 |
| Kootenai Medical CenterCoeur D'alene, ID | $2,567 |
| Northwest Specialty HospitalPost Falls, ID | $2,572 |
Highest
| Northwest Specialty HospitalPost Falls, ID | $2,572 |
|---|---|
| Kootenai Medical CenterCoeur D'alene, ID | $2,567 |
| St Lukes Regional Medical CenterBoise, ID | $2,527 |
| St Alphonsus Regional Medical CenterBoise, ID | $2,490 |
Level 3 Lower GI Procedures in other states
Questions
How much does level 3 lower gi procedures cost in Idaho?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 13 hospitals in Idaho was billed at $12,065 on average, while the average medicare-allowed amount was $2,530, of which Medicare paid $2,023. 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 4.8 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.