What 11 hospitals in Idaho charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.
Hospitals in Idaho billed an average of $15,541 for level 3 upper gi procedures, about 4.5 times the average medicare-allowed amount of $3,485. That payment is 4% below the U.S. average of $3,633.
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.
About 22¢ was paid for every $1 hospitals in Idaho billed for this service.
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 | 50 | $17,244 | $3,378 | $2,691 |
| Kootenai Medical CenterCoeur D'alene | 43 | $16,741 | $3,640 | $2,898 |
| St Alphonsus Regional Medical CenterBoise | 30 | $11,784 | $3,485 | $2,754 |
| Idaho Falls Community Hospital, LLCIdaho Falls | 18 | $12,214 | $3,446 | $2,746 |
| Mountain View HospitalIdaho Falls | 14 | $18,107 | $3,446 | $2,746 |
| St Lukes Magic Valley RMCTwin Falls | – | – | – | – |
| St Joseph Regional Medical CenterLewiston | – | – | – | – |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
| Portneuf Medical CenterPocatello | – | – | – | – |
| Northwest Specialty HospitalPost Falls | – | – | – | – |
| St Luke's Nampa Medical CenterNampa | – | – | – | – |
Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
| St Lukes Regional Medical CenterBoise, ID | $3,378 |
|---|---|
| Mountain View HospitalIdaho Falls, ID | $3,446 |
| Idaho Falls Community Hospital, LLCIdaho Falls, ID | $3,446 |
| St Alphonsus Regional Medical CenterBoise, ID | $3,485 |
| Kootenai Medical CenterCoeur D'alene, ID | $3,640 |
| Kootenai Medical CenterCoeur D'alene, ID | $3,640 |
|---|---|
| St Alphonsus Regional Medical CenterBoise, ID | $3,485 |
| Mountain View HospitalIdaho Falls, ID | $3,446 |
| Idaho Falls Community Hospital, LLCIdaho Falls, ID | $3,446 |
| St Lukes Regional Medical CenterBoise, ID | $3,378 |
In 2024 Medicare data, level 3 upper gi procedures (APC 5303) at 11 hospitals in Idaho was billed at $15,541 on average, while the average medicare-allowed amount was $3,485, of which Medicare paid $2,772. Your own cost depends on your insurance, deductible and the hospital.
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 4.5 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.