Medicare & Medicaid in Montana (MT)
2026 healthcare costs, coverage, and spending data for Montana.
$8,676
Spending/Capita
1,157,559
Medicare Enrollees
1,576,746
Medicaid Enrollees
2.9%
Uninsured Rate
Medicare Premiums in Montana
Part B Premium
$185/mo
Part D Premium (Avg)
$43/mo
Medigap Premium (Avg)
$291/mo
Medicaid Expansion: Yes - Montana expanded Medicaid under the ACA
Procedure Costs in Montana
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Liver Transplant | $159,407 | $127,525 | $31,881 |
| Kidney Transplant | $101,280 | $81,024 | $20,256 |
| Coronary Artery Bypass Graft (CABG) | $87,170 | $69,736 | $17,434 |
| Heart Valve Replacement | $74,302 | $59,442 | $14,860 |
| Spinal Fusion | $48,076 | $38,461 | $9,615 |
| Total Hip Replacement | $38,753 | $31,002 | $7,751 |
| Defibrillator Implantation (ICD) | $37,630 | $30,104 | $7,526 |
| Hip Fracture Repair | $30,490 | $24,392 | $6,098 |
| Total Knee Replacement | $27,456 | $21,965 | $5,491 |
| Laminectomy | $27,406 | $21,925 | $5,481 |
| Sepsis Treatment | $26,997 | $21,598 | $5,399 |
| Cardiac Catheterization with Stent | $25,517 | $20,413 | $5,103 |
| Pacemaker Implantation | $24,170 | $19,336 | $4,834 |
| Carotid Endarterectomy | $22,636 | $18,109 | $4,527 |
| Prostatectomy | $22,059 | $17,647 | $4,412 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Arthroscopic Knee Surgery | $8,438 | $6,751 | $1,688 |
| Lithotripsy (Kidney Stones) | $7,798 | $6,238 | $1,560 |
| TURP (Prostate) | $7,328 | $5,862 | $1,466 |
| Bunionectomy | $7,095 | $5,676 | $1,419 |
| Dialysis Access Surgery | $6,815 | $5,452 | $1,363 |
| Endoscopic Sinus Surgery | $6,470 | $5,176 | $1,294 |
| Septoplasty | $6,306 | $5,045 | $1,261 |
| Hemorrhoid Surgery | $6,169 | $4,935 | $1,234 |
| Tonsillectomy | $5,574 | $4,460 | $1,115 |
| Bronchoscopy | $4,293 | $3,434 | $859 |
| Carpal Tunnel Release | $4,053 | $3,242 | $811 |
| Nasal Polyp Removal | $3,967 | $3,174 | $793 |
| Adenoidectomy | $3,937 | $3,150 | $787 |
| Pilonidal Cyst Surgery | $3,872 | $3,097 | $774 |
| Ganglion Cyst Removal | $3,065 | $2,452 | $613 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $4,107 | $3,285 | $821 |
| Nuclear Stress Test | $1,660 | $1,328 | $332 |
| MRI Spine (Lumbar) | $1,437 | $1,149 | $287 |
| CT Angiography | $1,312 | $1,050 | $262 |
| MRI Brain | $1,197 | $958 | $239 |
| MRI Spine (Cervical) | $1,196 | $957 | $239 |
| MRI Knee | $1,114 | $891 | $223 |
| MRI Hip | $1,103 | $882 | $221 |
| MRI Shoulder | $1,079 | $863 | $216 |
| CT Scan Abdomen/Pelvis | $1,064 | $851 | $213 |
| CT Colonography (Virtual) | $860 | $688 | $172 |
| Bone Scan | $825 | $660 | $165 |
| CT Scan Chest | $802 | $641 | $160 |
| Fluoroscopy | $685 | $548 | $137 |
| CT Scan Head | $602 | $481 | $120 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Sleep Study Consultation | $338 | $271 | $68 |
| Psychiatry Visit | $293 | $235 | $59 |
| Allergy Testing | $254 | $203 | $51 |
| Wound Care Visit | $248 | $199 | $50 |
| Office Visit (New Patient) | $247 | $198 | $49 |
| Bone Density Test (DEXA Scan) | $237 | $189 | $47 |
| Mammogram (Screening) | $234 | $234 | $0 |
| Annual Wellness Visit | $222 | $222 | $0 |
| Shingles Vaccination | $184 | $184 | $0 |
| Office Visit (Established Patient) | $178 | $143 | $36 |
| Speech Therapy Session | $175 | $140 | $35 |
| Physical Therapy Session | $174 | $140 | $35 |
| Skin Cancer Screening | $170 | $136 | $34 |
| Mental Health Counseling | $169 | $135 | $34 |
| Occupational Therapy Session | $163 | $130 | $33 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $52 | $41 | $10 |
| Blood Type and Crossmatch | $49 | $39 | $10 |
| Comprehensive Metabolic Panel | $49 | $39 | $10 |
| Vitamin D Level | $49 | $39 | $10 |
| Glucose Tolerance Test | $46 | $37 | $9 |
| Liver Function Panel | $44 | $35 | $9 |
| Troponin Level | $43 | $34 | $9 |
| PSA (Prostate-Specific Antigen) | $43 | $34 | $9 |
| Blood Culture | $38 | $31 | $8 |
| Iron Studies (Ferritin) | $37 | $30 | $7 |
| Thyroid Panel (TSH) | $34 | $27 | $7 |
| Lipid Panel | $33 | $26 | $7 |
| Hemoglobin A1C | $32 | $26 | $6 |
| B12 Level | $32 | $26 | $6 |
| Pap Smear Lab Processing | $30 | $24 | $6 |
Compare Montana With Other States
Frequently Asked Questions
How much does Medicare spend per person in Montana?
In 2026, the average Medicare spending per beneficiary in Montana is $8,676.
How many people are enrolled in Medicare in Montana?
Montana has approximately 1,157,559 Medicare beneficiaries.
Did Montana expand Medicaid?
Yes, Montana expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in Montana?
The uninsured rate in Montana is 2.9%.
What is the average Medigap premium in Montana?
The average Medigap (Medicare Supplement) premium in Montana is $291 per month.