Level 3 Lower GI Procedures in Montana
What 9 hospitals in Montana charged and were paid for level 3 lower gi procedures (APC 5313), from 2024 Medicare claims.
Average charge
$11,189
Hospital list price billed
Average allowed
$2,662
Medicare's payment + patient's share
Medicare paid
$2,145
Average per service
State rank
#33 of 49
1 = lowest average payment
Hospitals in Montana billed an average of $11,189 for level 3 lower gi procedures, about 4.2 times the average medicare-allowed amount of $2,662. That payment is 2% below the U.S. average of $2,703.
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 $2,662Billed $11,189
About 24¢ was paid for every $1 hospitals in Montana billed for this service.
Montana hospitals: level 3 lower gi 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 |
|---|---|---|---|---|
| St Vincent HealthcareBillings | 32 | $12,558 | $2,631 | $2,155 |
| Logan Health Medical CenterKalispell | 30 | $9,262 | $2,819 | $2,274 |
| St Patrick Hospital and Health Sciences CenterMissoula | 23 | $8,006 | $2,632 | $2,124 |
| Benefis Hospitals INCGreat Falls | 20 | $17,042 | $2,528 | $1,990 |
| Billings Clinic HospitalBillings | 12 | $8,697 | $2,632 | $2,097 |
| St Peter's HospitalHelena | – | – | – | – |
| St James HealthcareButte | – | – | – | – |
| Community Medical Center INCMissoula | – | – | – | – |
| Bozeman Deaconess HospitalBozeman | – | – | – | – |
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 | $2,528 |
|---|---|
| St Vincent HealthcareBillings, MT | $2,631 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $2,632 |
| Billings Clinic HospitalBillings, MT | $2,632 |
| Logan Health Medical CenterKalispell, MT | $2,819 |
Highest
| Logan Health Medical CenterKalispell, MT | $2,819 |
|---|---|
| Billings Clinic HospitalBillings, MT | $2,632 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $2,632 |
| St Vincent HealthcareBillings, MT | $2,631 |
| Benefis Hospitals INCGreat Falls, MT | $2,528 |
Level 3 Lower GI Procedures in other states
Questions
How much does level 3 lower gi procedures cost in Montana?
In 2024 Medicare data, level 3 lower gi procedures (APC 5313) at 9 hospitals in Montana was billed at $11,189 on average, while the average medicare-allowed amount was $2,662, of which Medicare paid $2,145. 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 4.2 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.