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Eastern Idaho Regional Medical Center

Eastern Idaho Regional Medical Center in Idaho Falls charges 7.5x the Medicare reimbursement rate across 52 analyzed procedures, reflecting the pricing patterns at this for-profit hospital.

Idaho Falls, ID 83404 · Acute Care Hospitals · CMS Rating: 3/5

By David Park , Healthcare Cost Researcher · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.

52 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 5.3x3.0x15.0x
7.5x
Medicare markup ratio
ID lowestEastern Idaho Regional...ID highest
7.5x
Avg markup ratio
7.1x
Median markup
52
Procedures
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Billing patterns — for-profit

For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.

Pricing grade

D

High

Avg markup vs Medicare

7.51x

Charge / Medicare rate

Max markup

13.16x

Worst procedure

Procedures analyzed

52

With pricing data

Outlier procedures

0%

Above 90th percentile

Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.

ProcedureCodeGross chargeCash priceMedicareMarkup
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC322$170,659$85,32913.2x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$72,646$36,32312.1x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$160,932$80,46611.9x
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC917$112,376$56,18810.8x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC274$238,028$119,01410.2x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC287$74,467$37,23310.2x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O246$219,381$109,69110x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC243$153,726$76,8639.7x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$45,055$22,5279.3x
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC460$202,999$101,5009.1x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$41,728$20,8649x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC522$116,328$58,1648.5x
MAJOR CHEST PROCEDURES WITH MCC163$282,658$141,3298.5x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC481$120,001$60,0018.4x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC394$53,543$26,7718.2x
HYPERTENSION WITHOUT MCC305$32,657$16,3288.1x
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS208$149,315$74,6588x
MEDICAL BACK PROBLEMS WITHOUT MCC552$47,512$23,7567.9x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$47,155$23,5777.8x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC286$112,882$56,4417.6x
ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WIT062$90,664$45,3327.5x
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O023$299,039$149,5207.4x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC871$98,948$49,4747.3x
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC267$267,763$133,8827.3x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC064$92,546$46,2737.3x
GASTROINTESTINAL HEMORRHAGE WITH MCC377$85,631$42,8167.1x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC329$235,408$117,7047.1x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC455$240,095$120,0487x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$44,987$22,4946.9x
OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC091$87,216$43,6086.8x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC516$93,357$46,6796.6x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC280$68,972$34,4866.6x
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC025$205,502$102,7516.5x
CERVICAL SPINAL FUSION WITH CC472$140,033$70,0176.5x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC853$215,094$107,5476.4x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC698$69,562$34,7816.4x
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC689$50,314$25,1576.4x
RENAL FAILURE WITH MCC682$63,470$31,7356.3x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC177$68,446$34,2236.2x
RENAL FAILURE WITH CC683$34,246$17,1236.1x
RED BLOOD CELL DISORDERS WITH MCC811$59,857$29,9286x
HEART FAILURE AND SHOCK WITH MCC291$53,888$26,9446x
SIMPLE PNEUMONIA AND PLEURISY WITH MCC193$52,218$26,1096x
GASTROINTESTINAL HEMORRHAGE WITH CC378$41,644$20,8226x
COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC454$256,938$128,4695.8x
PULMONARY EDEMA AND RESPIRATORY FAILURE189$48,078$24,0395.8x
SEIZURES WITHOUT MCC101$34,316$17,1585.7x
SEIZURES WITH MCC100$74,684$37,3425.6x
GASTROINTESTINAL OBSTRUCTION WITH CC389$28,344$14,1725.4x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC391$37,692$18,8465.1x

Showing 50 of 52 procedures

How EASTERN IDAHO REGIONAL MEDICAL CENTER compares to nearby hospitals

Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.

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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?
Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.
Why do for-profit hospitals charge more than Medicare rates?
For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.
Does insurance typically pay the full hospital charge amount?
Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.
What should I know about billing differences between hospital types?
For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.

Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.

This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use

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