facebook tracking Level 2 Musculoskeletal Procedures cost in Montana: 10 hospitals compared (APC 5112)

Level 2 Musculoskeletal Procedures in Montana

What 10 hospitals in Montana charged and were paid for level 2 musculoskeletal procedures (APC 5112), from 2024 Medicare claims.

APC 5112 Outpatient 2024 Medicare data
Average charge $5,631 Hospital list price billed
Average allowed $1,516 Medicare's payment + patient's share
Medicare paid $1,202 Average per service
State rank #31 of 49 1 = lowest average payment

Hospitals in Montana billed an average of $5,631 for level 2 musculoskeletal procedures, about 3.7 times the average medicare-allowed amount of $1,516. That payment is about the same as the U.S. average of $1,511.

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 $1,516Billed $5,631

About 27¢ was paid for every $1 hospitals in Montana billed for this service.

Montana hospitals: level 2 musculoskeletal 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 115 $2,463 $1,499 $1,193
Benefis Hospitals INCGreat Falls 48 $4,684 $1,451 $1,142
Great Falls Clinic Medical CenterGreat Falls 48 $11,551 $1,507 $1,197
St Peter's HospitalHelena 40 $4,989 $1,519 $1,198
Bozeman Deaconess HospitalBozeman 37 $8,728 $1,614 $1,286
Logan Health Medical CenterKalispell 36 $6,927 $1,614 $1,281
St Patrick Hospital and Health Sciences CenterMissoula 30 $4,279 $1,467 $1,154
St Vincent HealthcareBillings 24 $5,970 $1,507 $1,200
Community Medical Center INCMissoula 11 $7,692 $1,507 $1,201
St James HealthcareButte – – – –
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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

Benefis Hospitals INCGreat Falls, MT$1,451
St Patrick Hospital and Health Sciences CenterMissoula, MT$1,467
Billings Clinic HospitalBillings, MT$1,499
Community Medical Center INCMissoula, MT$1,507
St Vincent HealthcareBillings, MT$1,507

Highest

Logan Health Medical CenterKalispell, MT$1,614
Bozeman Deaconess HospitalBozeman, MT$1,614
St Peter's HospitalHelena, MT$1,519
Great Falls Clinic Medical CenterGreat Falls, MT$1,507
St Vincent HealthcareBillings, MT$1,507

Level 2 Musculoskeletal Procedures in other states

Questions

How much does level 2 musculoskeletal procedures cost in Montana?

In 2024 Medicare data, level 2 musculoskeletal procedures (APC 5112) at 10 hospitals in Montana was billed at $5,631 on average, while the average medicare-allowed amount was $1,516, of which Medicare paid $1,202. 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 3.7 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.