Simple pneumonia and pleurisy with major complications in Montana
What 10 hospitals in Montana charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with major complications (DRG 193), from 2024 Medicare claims.
Average charge
$29,327
Hospital list price billed
Average payment
$10,500
Medicare + patient + other payers
Medicare paid
$8,867
Average per stay
State rank
#11 of 50
1 = lowest average payment
Hospitals in Montana billed an average of $29,327 for simple pneumonia and pleurisy with major complications, about 2.8 times the average total payment of $10,500. That payment is 13% below the U.S. average of $12,020.
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 $10,500Billed $29,327
About 36¢ was paid for every $1 hospitals in Montana billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Montana:
Montana hospitals: simple pneumonia and pleurisy with major complications
Every Montana hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Billings Clinic HospitalBillings | 113 | $24,497 | $10,771 | $9,361 |
| St Peter's HospitalHelena | 89 | $36,220 | $10,729 | $8,670 |
| Benefis Hospitals INCGreat Falls | 73 | $35,986 | $10,096 | $8,603 |
| Logan Health Medical CenterKalispell | 60 | $30,469 | $10,401 | $8,532 |
| St Vincent HealthcareBillings | 54 | $26,370 | $10,247 | $8,999 |
| St Patrick Hospital and Health Sciences CenterMissoula | 50 | $19,846 | $10,757 | $8,565 |
| Bozeman Deaconess HospitalBozeman | 50 | $23,688 | $9,955 | $8,748 |
| Community Medical Center INCMissoula | 18 | $43,524 | $10,301 | $8,290 |
| St James HealthcareButte | 17 | $28,278 | $12,631 | $11,289 |
| Great Falls Clinic Medical CenterGreat Falls | 15 | $33,039 | $9,136 | $7,830 |
Lowest and highest payments in Montana
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Great Falls Clinic Medical CenterGreat Falls, MT | $9,136 |
|---|---|
| Bozeman Deaconess HospitalBozeman, MT | $9,955 |
| Benefis Hospitals INCGreat Falls, MT | $10,096 |
| St Vincent HealthcareBillings, MT | $10,247 |
| Community Medical Center INCMissoula, MT | $10,301 |
Highest
| St James HealthcareButte, MT | $12,631 |
|---|---|
| Billings Clinic HospitalBillings, MT | $10,771 |
| St Patrick Hospital and Health Sciences CenterMissoula, MT | $10,757 |
| St Peter's HospitalHelena, MT | $10,729 |
| Logan Health Medical CenterKalispell, MT | $10,401 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Montana?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 10 hospitals in Montana was billed at $29,327 on average, while the average total payment was $10,500, of which Medicare paid $8,867. 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 stay in Montana, average charges were 2.8 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.