Kootenai Health

KOOTENAI HEALTH in Coeur d'Alene, Idaho charges 3.9x the Medicare reimbursement rate across 117 analyzed procedures, reflecting this government-owned hospital's pricing structure.

Coeur D'alene, ID 83814 · Acute Care Hospitals · CMS Rating: 4/5

By Priya Iyengar , Senior Billing Analyst · Published March 15, 2026 · Updated April 3, 2026

Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.

About the analyst

Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.

117 procedures analyzed

CMS price transparency data

Updated 2026-04-03

3.9x

Medicare markup ratio

ID lowestKootenai HealthID highest

3.9x

Avg markup ratio

3.9x

Median markup

117

Procedures

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Billing patterns — government

Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.

Pricing grade

Average

Avg markup vs Medicare

3.93x

Charge / Medicare rate

Max markup

6.06x

Worst procedure

Procedures analyzed

117

With pricing data

Outlier procedures

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.

Procedure	Code	Gross charge	Cash price	Medicare	Markup
HEART FAILURE AND SHOCK WITH CC	292	$32,501	$16,251	—	6.1x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	470	$75,820	$37,910	—	5.8x
DIABETES WITH CC	638	$34,011	$17,006	—	5.8x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	281	$35,341	$17,671	—	5.7x
OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC	357	$92,224	$46,112	—	5.7x
DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC	442	$35,128	$17,564	—	5.6x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC	247	$68,063	$34,031	—	5.5x
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC	190	$36,274	$18,137	—	5.3x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC	287	$36,230	$18,115	—	5.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC	322	$65,278	$32,639	—	5.2x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC	309	$23,033	$11,516	—	5.1x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC	522	$77,928	$38,964	—	5x
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC	236	$144,179	$72,089	—	5x
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC	092	$31,075	$15,537	—	4.9x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC	516	$60,397	$30,199	—	4.9x
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC	039	$36,827	$18,414	—	4.9x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O	246	$98,448	$49,224	—	4.8x
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC	234	$176,166	$88,083	—	4.8x
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION	220	$195,115	$97,558	—	4.8x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC	066	$19,779	$9,890	—	4.7x
AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC	617	$52,828	$26,414	—	4.6x
FRACTURES OF HIP AND PELVIS WITHOUT MCC	536	$20,397	$10,199	—	4.5x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC	393	$56,607	$28,303	—	4.5x
REVISION OF HIP OR KNEE REPLACEMENT WITH CC	467	$100,992	$50,496	—	4.5x
MEDICAL BACK PROBLEMS WITHOUT MCC	552	$27,962	$13,981	—	4.5x
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC	641	$20,777	$10,389	—	4.4x
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC	235	$227,208	$113,604	—	4.4x
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC	460	$114,269	$57,135	—	4.4x
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC	689	$31,515	$15,758	—	4.4x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC	418	$48,627	$24,313	—	4.4x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC	390	$14,340	$7,170	—	4.3x
PSYCHOSES	885	$40,155	$20,077	—	4.3x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC	392	$20,678	$10,339	—	4.3x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS	065	$26,028	$13,014	—	4.3x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC	274	$101,442	$50,721	—	4.3x
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC	493	$67,125	$33,562	—	4.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/	321	$85,666	$42,833	—	4.2x
SEIZURES WITH MCC	100	$55,323	$27,662	—	4.2x
EXTRACRANIAL PROCEDURES WITH CC	038	$46,598	$23,299	—	4.2x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC	481	$58,487	$29,244	—	4.2x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC	517	$40,978	$20,489	—	4.2x
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC	233	$270,781	$135,390	—	4.1x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC	286	$62,155	$31,077	—	4.1x
PULMONARY EDEMA AND RESPIRATORY FAILURE	189	$32,039	$16,019	—	4.1x
AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC	269	$122,792	$61,396	—	4.1x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC	308	$31,753	$15,877	—	4.1x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC	178	$25,173	$12,587	—	4.1x
RENAL FAILURE WITH CC	683	$21,940	$10,970	—	4x
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE	175	$33,832	$16,916	—	4x
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC	267	$148,661	$74,330	—	4x

Showing 50 of 117 procedures

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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 — government hospital billing

How do government hospital billing rates compare to Medicare benchmarks?

Based on available data from 374 government hospitals, charges average 4.2 times the Medicare benchmark rates. Government hospitals, while publicly owned, still establish their own pricing structures that can result in charges above standard Medicare rates.

Why do government hospitals charge above Medicare rates if they're publicly owned?

Government hospitals operate as independent entities that must cover operational costs, equipment, and staffing expenses. Public ownership doesn't require hospitals to limit charges to Medicare benchmark levels, as they still need to maintain financial sustainability for continued operations.

What should I expect when reviewing a government hospital bill?

Government hospital bills typically show charges that may be several times higher than Medicare benchmark rates, with the average markup being approximately 4.2x across sampled facilities. The final amount you pay will depend on your insurance coverage, negotiated rates, and any applicable financial assistance programs.

Are there potential billing differences between government hospitals and other facility types?

Government hospitals show similar billing patterns to other hospital types, with charges typically set above Medicare benchmarks. The potential difference in what patients ultimately pay often depends more on individual insurance plans and hospital financial assistance policies than on the ownership structure of the facility.

Related pricing data

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Coeur D'alene, ID costsCity-level pricing data

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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