facebook tracking Level 3 Upper GI Procedures cost in Idaho: 11 hospitals compared (APC 5303)

Level 3 Upper GI Procedures in Idaho

What 11 hospitals in Idaho charged and were paid for level 3 upper gi procedures (APC 5303), from 2024 Medicare claims.

APC 5303 Outpatient 2024 Medicare data
Average charge $15,541 Hospital list price billed
Average allowed $3,485 Medicare's payment + patient's share
Medicare paid $2,772 Average per service
State rank #25 of 48 1 = lowest average payment

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.

Paid $3,485Billed $15,541

About 22¢ was paid for every $1 hospitals in Idaho billed for this service.

Idaho hospitals: level 3 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
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 – – – –
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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.

Lowest

Highest

Level 3 Upper GI Procedures in other states

Questions

How much does level 3 upper gi procedures cost in Idaho?

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.

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 4.5 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.