Level 3 Extraocular, Repair, and Plastic Eye Procedures in Montana
What 8 hospitals in Montana charged and were paid for level 3 extraocular, repair, and plastic eye procedures (APC 5503), from 2024 Medicare claims.
Average charge
$4,815
Hospital list price billed
Average allowed
$2,191
Medicare's payment + patient's share
Medicare paid
$1,744
Average per service
State rank
#29 of 45
1 = lowest average payment
Hospitals in Montana billed an average of $4,815 for level 3 extraocular, repair, and plastic eye procedures, about 2.2 times the average medicare-allowed amount of $2,191. That payment is 2% below the U.S. average of $2,242.
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 $2,191Billed $4,815
About 46¢ was paid for every $1 hospitals in Montana billed for this service.
Montana hospitals: level 3 extraocular, repair, and plastic eye 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 | 42 | $3,136 | $2,191 | $1,744 |
| Benefis Hospitals INCGreat Falls | 11 | $11,223 | $2,191 | $1,745 |
| St Peter's HospitalHelena | – | – | – | – |
| St Patrick Hospital and Health Sciences CenterMissoula | – | – | – | – |
| St Vincent HealthcareBillings | – | – | – | – |
| Logan Health Medical CenterKalispell | – | – | – | – |
| Bozeman Deaconess HospitalBozeman | – | – | – | – |
| Great Falls Clinic Medical CenterGreat Falls | – | – | – | – |
Level 3 Extraocular, Repair, and Plastic Eye Procedures in other states
Questions
How much does level 3 extraocular, repair, and plastic eye procedures cost in Montana?
In 2024 Medicare data, level 3 extraocular, repair, and plastic eye procedures (APC 5503) at 8 hospitals in Montana was billed at $4,815 on average, while the average medicare-allowed amount was $2,191, of which Medicare paid $1,744. 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 2.2 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.