facebook tracking Level 3 Intraocular Procedures cost in Montana: 6 hospitals compared (APC 5493)

Level 3 Intraocular Procedures in Montana

What 6 hospitals in Montana charged and were paid for level 3 intraocular procedures (APC 5493), from 2024 Medicare claims.

APC 5493 Outpatient 2024 Medicare data
Average charge $14,117 Hospital list price billed
Average allowed $4,846 Medicare's payment + patient's share
Medicare paid $3,847 Average per service
State rank #28 of 42 1 = lowest average payment

Hospitals in Montana billed an average of $14,117 for level 3 intraocular procedures, about 2.9 times the average medicare-allowed amount of $4,846. That payment is 4% below the U.S. average of $5,041.

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 $4,846Billed $14,117

About 34¢ was paid for every $1 hospitals in Montana billed for this service.

Montana hospitals: level 3 intraocular 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 45 $9,571 $4,818 $3,817
Great Falls Clinic Medical CenterGreat Falls 23 $23,011 $4,900 $3,904
Benefis Hospitals INCGreat Falls – – – –
St Patrick Hospital and Health Sciences CenterMissoula – – – –
Logan Health Medical CenterKalispell – – – –
Bozeman Deaconess HospitalBozeman – – – –
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Level 3 Intraocular Procedures in other states

Questions

How much does level 3 intraocular procedures cost in Montana?

In 2024 Medicare data, level 3 intraocular procedures (APC 5493) at 6 hospitals in Montana was billed at $14,117 on average, while the average medicare-allowed amount was $4,846, of which Medicare paid $3,847. 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 2.9 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.