Montana · 99156

Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes in Montana

Montana Medicare Avg
$59.72
3% above national avg
National Medicare Avg
$57.85
All states combined
Billed Charge (MT)
$163.11
What providers submit
Est. Commercial (MT)
$157.02
National avg: $165.31
Est. Cash / Self-Pay (MT)
$100.93
Typical self-pay discount

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

33
Services in MT
14
Providers
N/A
Min Payment
N/A
Max Payment

Montana Pricing in Context

In Montana, CPT code 99156 (Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes) carries an average Medicare payment of $59.72 — 3% above the national benchmark of $57.85. 14 providers across the state submitted claims for this procedure in 2023, performing 33 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 $163.11, 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 above the national Medicare average, commercial rates in the state may also run higher than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Other procedures, the estimated commercial insurance price in Montana lands near $157.02, with self-pay cash prices typically around $100.93. 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 Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes cost in Montana?

The average Medicare payment for Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes in Montana is $59.72, which is 3% above the national average of $57.85. Providers in MT typically bill $163.11 for this procedure.

What does Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes cost with insurance in Montana?

With commercial insurance in Montana, Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes costs an estimated $157.02. Without insurance, the estimated cash price is $100.93. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes in Montana?

14 providers in Montana billed Medicare for Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes in 2023, performing 33 total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes cheaper in Montana than the national average?

No — Use Of A Drug To Induce Depression Of Consciousness By Physician Not Performing A Procedure (5 Years Or Older), Initial 15 Minutes costs 3% above the national average in Montana. The state average Medicare payment is $59.72 compared to $57.85 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