Level 1 Breast/Lymphatic Surgery and Related Procedures in Montana
What 10 hospitals in Montana charged and were paid for level 1 breast/lymphatic surgery and related procedures (APC 5091), from 2024 Medicare claims.
Average charge
$15,666
Hospital list price billed
Average allowed
$3,630
Medicare's payment + patient's share
Medicare paid
$2,889
Average per service
State rank
#33 of 49
1 = lowest average payment
Hospitals in Montana billed an average of $15,666 for level 1 breast/lymphatic surgery and related procedures, about 4.3 times the average medicare-allowed amount of $3,630. That payment is 2% below the U.S. average of $3,688.
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 $3,630Billed $15,666
About 23¢ was paid for every $1 hospitals in Montana billed for this service.
Montana hospitals: level 1 breast/lymphatic surgery and related procedures
Every Montana hospital that billed Medicare for this service at least 11 times. Click a column to sort.
| Hospital | Services | Avg charge | Avg allowed | Medicare paid |
|---|---|---|---|---|
| Billings Clinic HospitalBillings | 63 | $7,491 | $3,540 | $2,820 |
| St Patrick Hospital and Health Sciences CenterMissoula | 37 | $15,335 | $3,574 | $2,842 |
| Logan Health Medical CenterKalispell | 35 | $16,287 | $3,742 | $2,962 |
| Community Medical Center INCMissoula | 28 | $32,860 | $3,574 | $2,847 |
| Bozeman Deaconess HospitalBozeman | 26 | $17,481 | $3,827 | $3,049 |
| St Vincent HealthcareBillings | 25 | $15,590 | $3,574 | $2,847 |
| St Peter's HospitalHelena | 23 | $14,952 | $3,753 | $2,990 |
| Benefis Hospitals INCGreat Falls | 22 | $15,453 | $3,574 | $2,847 |
| St James HealthcareButte | – | – | – | – |
| Great Falls Clinic Medical CenterGreat Falls | – | – | – | – |
Lowest and highest allowed amounts in Montana
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
| Billings Clinic HospitalBillings, MT | $3,540 |
|---|---|
| Benefis Hospitals INCGreat Falls, MT | $3,574 |
| Community Medical Center INCMissoula, MT | $3,574 |
| St Vincent HealthcareBillings, MT | $3,574 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $3,574 |
Highest
| Bozeman Deaconess HospitalBozeman, MT | $3,827 |
|---|---|
| St Peter's HospitalHelena, MT | $3,753 |
| Logan Health Medical CenterKalispell, MT | $3,742 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $3,574 |
| Benefis Hospitals INCGreat Falls, MT | $3,574 |
Level 1 Breast/Lymphatic Surgery and Related Procedures in other states
Questions
How much does level 1 breast/lymphatic surgery and related procedures cost in Montana?
In 2024 Medicare data, level 1 breast/lymphatic surgery and related procedures (APC 5091) at 10 hospitals in Montana was billed at $15,666 on average, while the average medicare-allowed amount was $3,630, of which Medicare paid $2,889. 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 Montana, average charges were 4.3 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.