facebook tracking Level 5 ENT Procedures cost in Idaho: 10 hospitals compared (APC 5165)

Level 5 ENT Procedures in Idaho

What 10 hospitals in Idaho charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.

APC 5165 Outpatient 2024 Medicare data
Average charge $26,402 Hospital list price billed
Average allowed $5,315 Medicare's payment + patient's share
Medicare paid $4,227 Average per service
State rank #26 of 49 1 = lowest average payment

Hospitals in Idaho billed an average of $26,402 for level 5 ent procedures, about 5.0 times the average medicare-allowed amount of $5,315. That payment is 5% below the U.S. average of $5,586.

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 $5,315Billed $26,402

About 20¢ was paid for every $1 hospitals in Idaho billed for this service.

Idaho hospitals: level 5 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
Mountain View HospitalIdaho Falls 65 $19,285 $5,011 $3,979
St Lukes Regional Medical CenterBoise 64 $22,522 $5,270 $4,197
Kootenai Medical CenterCoeur D'alene 27 $24,042 $5,565 $4,434
St Lukes Magic Valley RMCTwin Falls 26 $22,820 $5,644 $4,495
Portneuf Medical CenterPocatello 20 $50,785 $5,644 $4,497
St Alphonsus Regional Medical CenterBoise 15 $22,665 $5,367 $4,215
Eastern Idaho Regional Medical CenterIdaho Falls 13 $68,306 $5,270 $4,199
Northwest Specialty HospitalPost Falls 11 $16,541 $5,366 $4,275
Saint Alphonsus Medical Center - NampaNampa – – – –
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.

Highest

St Lukes Magic Valley RMCTwin Falls, ID$5,644
Portneuf Medical CenterPocatello, ID$5,644
Kootenai Medical CenterCoeur D'alene, ID$5,565
St Alphonsus Regional Medical CenterBoise, ID$5,367
Northwest Specialty HospitalPost Falls, ID$5,366

Level 5 ENT Procedures in other states

Questions

How much does level 5 ent procedures cost in Idaho?

In 2024 Medicare data, level 5 ent procedures (APC 5165) at 10 hospitals in Idaho was billed at $26,402 on average, while the average medicare-allowed amount was $5,315, of which Medicare paid $4,227. 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 5.0 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.