Level 4 ENT Procedures in Idaho
What 13 hospitals in Idaho charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.
Average charge
$14,486
Hospital list price billed
Average allowed
$2,653
Medicare's payment + patient's share
Medicare paid
$2,098
Average per service
State rank
#13 of 48
1 = lowest average payment
Hospitals in Idaho billed an average of $14,486 for level 4 ent procedures, about 5.5 times the average medicare-allowed amount of $2,653. That payment is 5% below the U.S. average of $2,798.
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 $2,653Billed $14,486
About 18¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 4 ent 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 | 28 | $17,897 | $2,898 | $2,302 |
| St Lukes Magic Valley RMCTwin Falls | 22 | $21,938 | $2,999 | $2,360 |
| Northwest Specialty HospitalPost Falls | 22 | $11,152 | $2,843 | $2,243 |
| Mountain View HospitalIdaho Falls | 17 | $10,239 | $2,762 | $2,173 |
| Kootenai Medical CenterCoeur D'alene | 16 | $7,019 | $1,530 | $1,212 |
| Portneuf Medical CenterPocatello | 15 | $14,857 | $2,482 | $1,978 |
| St Joseph Regional Medical CenterLewiston | – | – | – | – |
| St Alphonsus Regional Medical CenterBoise | – | – | – | – |
| Saint Alphonsus Medical Center - NampaNampa | – | – | – | – |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
| Madison Memorial HospitalRexburg | – | – | – | – |
| Treasure Valley HospitalBoise | – | – | – | – |
| 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
| Kootenai Medical CenterCoeur D'alene, ID | $1,530 |
|---|---|
| Portneuf Medical CenterPocatello, ID | $2,482 |
| Mountain View HospitalIdaho Falls, ID | $2,762 |
| Northwest Specialty HospitalPost Falls, ID | $2,843 |
| St Lukes Regional Medical CenterBoise, ID | $2,898 |
Highest
| St Lukes Magic Valley RMCTwin Falls, ID | $2,999 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $2,898 |
| Northwest Specialty HospitalPost Falls, ID | $2,843 |
| Mountain View HospitalIdaho Falls, ID | $2,762 |
| Portneuf Medical CenterPocatello, ID | $2,482 |
Level 4 ENT Procedures in other states
Questions
How much does level 4 ent procedures cost in Idaho?
In 2024 Medicare data, level 4 ent procedures (APC 5164) at 13 hospitals in Idaho was billed at $14,486 on average, while the average medicare-allowed amount was $2,653, of which Medicare paid $2,098. 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 5.5 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.