Simple pneumonia and pleurisy with major complications in Idaho
What 10 hospitals in Idaho charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with major complications (DRG 193), from 2024 Medicare claims.
Average charge
$44,230
Hospital list price billed
Average payment
$11,075
Medicare + patient + other payers
Medicare paid
$9,070
Average per stay
State rank
#20 of 50
1 = lowest average payment
Hospitals in Idaho billed an average of $44,230 for simple pneumonia and pleurisy with major complications, about 4.0 times the average total payment of $11,075. That payment is 8% below the U.S. average of $12,020.
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 $11,075Billed $44,230
About 25¢ was paid for every $1 hospitals in Idaho billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Idaho:
Idaho hospitals: simple pneumonia and pleurisy with major complications
Every Idaho hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| St Lukes Regional Medical CenterBoise | 99 | $45,477 | $10,402 | $8,813 |
| Kootenai Medical CenterCoeur D'alene | 74 | $31,662 | $9,666 | $8,035 |
| St Lukes Magic Valley RMCTwin Falls | 68 | $39,035 | $10,717 | $9,027 |
| Eastern Idaho Regional Medical CenterIdaho Falls | 55 | $61,842 | $11,316 | $8,403 |
| Portneuf Medical CenterPocatello | 42 | $62,644 | $12,789 | $11,196 |
| St Alphonsus Regional Medical CenterBoise | 35 | $41,659 | $11,532 | $9,164 |
| St Joseph Regional Medical CenterLewiston | 31 | $29,555 | $12,616 | $10,557 |
| St Luke's Nampa Medical CenterNampa | 28 | $45,646 | $11,012 | $9,596 |
| Saint Alphonsus Medical Center - NampaNampa | 20 | $41,920 | $13,737 | $8,377 |
| Idaho Falls Community Hospital, LLCIdaho Falls | 11 | $41,415 | $10,591 | $9,256 |
Lowest and highest payments in Idaho
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Kootenai Medical CenterCoeur D'alene, ID | $9,666 |
|---|---|
| St Lukes Regional Medical CenterBoise, ID | $10,402 |
| Idaho Falls Community Hospital, LLCIdaho Falls, ID | $10,591 |
| St Lukes Magic Valley RMCTwin Falls, ID | $10,717 |
| St Luke's Nampa Medical CenterNampa, ID | $11,012 |
Highest
| Saint Alphonsus Medical Center - NampaNampa, ID | $13,737 |
|---|---|
| Portneuf Medical CenterPocatello, ID | $12,789 |
| St Joseph Regional Medical CenterLewiston, ID | $12,616 |
| St Alphonsus Regional Medical CenterBoise, ID | $11,532 |
| Eastern Idaho Regional Medical CenterIdaho Falls, ID | $11,316 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Idaho?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 10 hospitals in Idaho was billed at $44,230 on average, while the average total payment was $11,075, of which Medicare paid $9,070. 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 stay in Idaho, average charges were 4.0 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.