Likely match: HoLEP prostate surgery
Likely code mapping
Boise-area facility comparison
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Choose an insurance carrier and describe the urology procedure or condition in plain language. This page maps common BPH, HoLEP, vasectomy, kidney stone, bladder, and urinary conditions to likely billing codes and gives a Boise-area planning estimate.
This tool uses common urology code mappings and public price-transparency style ranges for Boise-area facilities. It is for planning only and is not a quote.
Likely match: HoLEP prostate surgery
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The total cost is not always one bill. Patients may receive separate statements from the urologist, facility, anesthesia group, pathology lab, laboratory, imaging center, or medical device supplier.
The deductible is the amount you pay before many insurance benefits begin. If you have $1,500 remaining and the allowed amount is higher than that, you usually pay that $1,500 first.
A co-pay is a fixed amount. Coinsurance is a percentage of the allowed amount after your deductible. For procedures, coinsurance often matters more than a small office co-pay.
This is the most you should pay for covered in-network care during the plan year. Premiums, non-covered services, and out-of-network care may not count.
The urologist bills for the procedure and related professional services. This is separate from a hospital, surgery center, anesthesia, pathology, imaging, lab, or device charge when those apply.
Anesthesia bills depend partly on case length. Pathology may apply when tissue, prostate chips, stones, or biopsies are examined. Facility charges can include the procedure room, laser or device supplies, recovery, medications, and nursing care.
A urology office may charge a scheduling fee because staff must reserve procedure or operating room time, coordinate authorization, check benefits, arrange pre-op testing, manage device or laser resources, and handle cancellations that can leave unused procedural time.
Use your member portal to find deductible remaining, out-of-pocket remaining, in-network providers, prior authorization rules, and procedure cost estimators.
Information about Idaho medical billing transparency and medical debt collection protections.
Open Idaho Patient ActFederal protections for many surprise bills, including some out-of-network bills at in-network facilities.
Open CMS No SurprisesThe Idaho Department of Insurance explains surprise billing protections and complaint options for Idaho patients.
Open Idaho DOIThese answers summarize how patients can use the calculator, what to ask insurance, and why final urology bills can differ from an estimate.
This calculator is useful for planning, but it is not a final quote. Actual cost depends on diagnosis, CPT codes, insurance contract, deductible, coinsurance, out-of-pocket maximum, authorization, facility, anesthesia time, pathology, lab testing, implants, supplies, and final coding.
Insurance changes urology procedure cost because each plan may have different contracted rates, network rules, deductibles, coinsurance, prior authorization requirements, and out-of-pocket limits. If carrier-specific data is not available, the calculator shows an Average cost.
Patients may receive separate bills from the urologist, hospital or surgery center, anesthesia group, pathology lab, imaging services, laboratory, device or supply vendors, and other services related to the procedure.
Ask Dr. Slade's office for the expected CPT codes, ask the facility for a written estimate, and ask your insurance carrier for the in-network allowed amount and your expected patient responsibility.
The calculator includes planning ranges and estimate links for Treasure Valley Hospital, St. Luke's Boise or Meridian, Saint Alphonsus Boise or Nampa, and West Valley Medical Center. Office-based procedures may not use a hospital estimator.
This calculator is an educational planning tool only. It may be incomplete or inaccurate. It does not verify eligibility, network status, prior authorization, medical necessity, covered benefits, modifiers, bundled services, anesthesia time, pathology, complications, implants, facility choice, or final coding. Your actual bill may be higher or lower.
Before scheduling a urology procedure, request written estimates from the facility, anesthesia group, pathology lab, laboratory, imaging center, or device supplier when applicable. Ask your insurer for the allowed amount and your expected patient responsibility for the CPT codes shown here.