Level 6 Musculoskeletal Procedures in Idaho
What 15 hospitals in Idaho charged and were paid for level 6 musculoskeletal procedures (APC 5116), from 2024 Medicare claims.
Average charge
$69,688
Hospital list price billed
Average allowed
$16,900
Medicare's payment + patient's share
Medicare paid
$15,268
Average per service
State rank
#25 of 49
1 = lowest average payment
Hospitals in Idaho billed an average of $69,688 for level 6 musculoskeletal procedures, about 4.1 times the average medicare-allowed amount of $16,900. That payment is 3% below the U.S. average of $17,392.
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 $16,900Billed $69,688
About 24¢ was paid for every $1 hospitals in Idaho billed for this service.
Idaho hospitals: level 6 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 |
|---|---|---|---|---|
| Treasure Valley HospitalBoise | 145 | $63,523 | $16,423 | $14,790 |
| Northwest Specialty HospitalPost Falls | 115 | $71,689 | $17,038 | $15,406 |
| Mountain View HospitalIdaho Falls | 92 | $48,908 | $16,735 | $15,103 |
| St Alphonsus Regional Medical CenterBoise | 78 | $49,106 | $16,949 | $15,315 |
| St Lukes Regional Medical CenterBoise | 68 | $56,303 | $16,293 | $14,671 |
| St Joseph Regional Medical CenterLewiston | 64 | $89,773 | $17,412 | $15,780 |
| Portneuf Medical CenterPocatello | 41 | $147,182 | $17,921 | $16,283 |
| St Lukes Magic Valley RMCTwin Falls | 33 | $56,309 | $17,428 | $15,796 |
| St Luke's Nampa Medical CenterNampa | 25 | $48,936 | $16,735 | $15,103 |
| Kootenai Medical CenterCoeur D'alene | 24 | $62,122 | $17,671 | $16,039 |
| Madison Memorial HospitalRexburg | 21 | $62,932 | $16,788 | $15,156 |
| Saint Alphonsus Medical Center - NampaNampa | 18 | $50,899 | $17,998 | $16,366 |
| West Valley Medical CenterCaldwell | 17 | $202,080 | $15,847 | $14,215 |
| Eastern Idaho Regional Medical CenterIdaho Falls | – | – | – | – |
| 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
| West Valley Medical CenterCaldwell, ID | $15,847 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $16,293 |
| Treasure Valley HospitalBoise, ID | $16,423 |
| St Luke's Nampa Medical CenterNampa, ID | $16,735 |
| Mountain View HospitalIdaho Falls, ID | $16,735 |
Highest
| Saint Alphonsus Medical Center - NampaNampa, ID | $17,998 |
|---|---|
| Portneuf Medical CenterPocatello, ID | $17,921 |
| Kootenai Medical CenterCoeur D'alene, ID | $17,671 |
| St Lukes Magic Valley RMCTwin Falls, ID | $17,428 |
| St Joseph Regional Medical CenterLewiston, ID | $17,412 |
Level 6 Musculoskeletal Procedures in other states
Questions
How much does level 6 musculoskeletal procedures cost in Idaho?
In 2024 Medicare data, level 6 musculoskeletal procedures (APC 5116) at 15 hospitals in Idaho was billed at $69,688 on average, while the average medicare-allowed amount was $16,900, of which Medicare paid $15,268. 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 4.1 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.