Level 3 Musculoskeletal Procedures in Idaho
What 15 hospitals in Idaho charged and were paid for level 3 musculoskeletal procedures (APC 5113), from 2024 Medicare claims.
Average charge
$15,036
Hospital list price billed
Average allowed
$2,879
Medicare's payment + patient's share
Medicare paid
$2,283
Average per service
State rank
#22 of 49
1 = lowest average payment
Hospitals in Idaho billed an average of $15,036 for level 3 musculoskeletal procedures, about 5.2 times the average medicare-allowed amount of $2,879. That payment is 4% below the U.S. average of $2,995.
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 $2,879Billed $15,036
About 19¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 3 musculoskeletal 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 | 161 | $9,010 | $2,842 | $2,248 |
| St Lukes Regional Medical CenterBoise | 113 | $11,289 | $2,369 | $1,880 |
| Kootenai Medical CenterCoeur D'alene | 93 | $14,370 | $3,052 | $2,425 |
| Northwest Specialty HospitalPost Falls | 91 | $16,667 | $2,940 | $2,335 |
| Treasure Valley HospitalBoise | 80 | $16,954 | $2,847 | $2,262 |
| St Alphonsus Regional Medical CenterBoise | 74 | $13,705 | $3,066 | $2,427 |
| St Lukes Magic Valley RMCTwin Falls | 73 | $11,002 | $3,086 | $2,447 |
| Madison Memorial HospitalRexburg | 48 | $8,832 | $2,922 | $2,322 |
| Portneuf Medical CenterPocatello | 46 | $29,215 | $2,941 | $2,304 |
| Eastern Idaho Regional Medical CenterIdaho Falls | 43 | $32,353 | $2,913 | $2,320 |
| Saint Alphonsus Medical Center - NampaNampa | 36 | $13,832 | $3,064 | $2,426 |
| West Valley Medical CenterCaldwell | 36 | $24,696 | $2,913 | $2,318 |
| St Joseph Regional Medical CenterLewiston | 27 | $20,571 | $3,120 | $2,486 |
| St Luke's Nampa Medical CenterNampa | 18 | $14,685 | $2,589 | $2,063 |
| 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 | $2,369 |
|---|---|
| St Luke's Nampa Medical CenterNampa, ID | $2,589 |
| Mountain View HospitalIdaho Falls, ID | $2,842 |
| Treasure Valley HospitalBoise, ID | $2,847 |
| Eastern Idaho Regional Medical CenterIdaho Falls, ID | $2,913 |
Highest
| St Joseph Regional Medical CenterLewiston, ID | $3,120 |
|---|---|
| St Lukes Magic Valley RMCTwin Falls, ID | $3,086 |
| St Alphonsus Regional Medical CenterBoise, ID | $3,066 |
| Saint Alphonsus Medical Center - NampaNampa, ID | $3,064 |
| Kootenai Medical CenterCoeur D'alene, ID | $3,052 |
Level 3 Musculoskeletal Procedures in other states
Questions
How much does level 3 musculoskeletal procedures cost in Idaho?
In 2024 Medicare data, level 3 musculoskeletal procedures (APC 5113) at 15 hospitals in Idaho was billed at $15,036 on average, while the average medicare-allowed amount was $2,879, of which Medicare paid $2,283. 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 5.2 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.