Montana · 36573

Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Montana

Montana Medicare Avg
$64.85
15% below national avg
National Medicare Avg
$76.18
All states combined
Billed Charge (MT)
$400.72
What providers submit
Est. Commercial (MT)
$173.53
National avg: $216.70
Est. Cash / Self-Pay (MT)
$172.18
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

180
Services in MT
13
Providers
N/A
Min Payment
N/A
Max Payment

Montana Pricing in Context

In Montana, CPT code 36573 (Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older) carries an average Medicare payment of $64.85 — 15% below the national benchmark of $76.18. 13 providers across the state submitted claims for this procedure in 2023, performing 180 total services. Individual payments in MT ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Montana is $400.72, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Montana sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Cardiovascular Surgery procedures, the estimated commercial insurance price in Montana lands near $173.53, with self-pay cash prices typically around $172.18. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cost in Montana?

The average Medicare payment for Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Montana is $64.85, which is 15% below the national average of $76.18. Providers in MT typically bill $400.72 for this procedure.

What does Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cost with insurance in Montana?

With commercial insurance in Montana, Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older costs an estimated $173.53. Without insurance, the estimated cash price is $172.18. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in Montana?

13 providers in Montana billed Medicare for Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older in 2023, performing 180 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older cheaper in Montana than the national average?

Yes — Insertion Of Tube For Infusion With Imaging Guidance And Review By Radiologist, Patient 5 Years Or Older costs 15% below the national average in Montana. The state average Medicare payment is $64.85 compared to $76.18 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial