Level 3 ENT Procedures in Montana
What 8 hospitals in Montana charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.
Average charge
$2,233
Hospital list price billed
Average allowed
$1,427
Medicare's payment + patient's share
Medicare paid
$1,136
Average per service
State rank
#32 of 44
1 = lowest average payment
Hospitals in Montana billed an average of $2,233 for level 3 ent procedures, about 1.6 times the average medicare-allowed amount of $1,427. That payment is 2% above the U.S. average of $1,397.
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 $1,427Billed $2,233
About 64¢ was paid for every $1 hospitals in Montana billed for this service.
Montana hospitals: level 3 ent 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 | 33 | $1,679 | $1,326 | $1,054 |
| St Peter's HospitalHelena | 22 | $3,263 | $1,502 | $1,196 |
| Bozeman Deaconess HospitalBozeman | 16 | $1,961 | $1,531 | $1,220 |
| Benefis Hospitals INCGreat Falls | – | – | – | – |
| St Patrick Hospital and Health Sciences CenterMissoula | – | – | – | – |
| St James HealthcareButte | – | – | – | – |
| St Vincent HealthcareBillings | – | – | – | – |
| Logan Health Medical CenterKalispell | – | – | – | – |
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 | $1,326 |
|---|---|
| St Peter's HospitalHelena, MT | $1,502 |
| Bozeman Deaconess HospitalBozeman, MT | $1,531 |
Highest
| Bozeman Deaconess HospitalBozeman, MT | $1,531 |
|---|---|
| St Peter's HospitalHelena, MT | $1,502 |
| Billings Clinic HospitalBillings, MT | $1,326 |
Level 3 ENT Procedures in other states
Questions
How much does level 3 ent procedures cost in Montana?
In 2024 Medicare data, level 3 ent procedures (APC 5163) at 8 hospitals in Montana was billed at $2,233 on average, while the average medicare-allowed amount was $1,427, of which Medicare paid $1,136. 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 1.6 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.