What common medical visits cost in Montana - and how they compare to nearby states

In the patchwork of health care providers in the United States, determining what a medical visit might cost can be confusing at best and life-altering at worst. The vast majority of patients who arrive at the hospital for a service recommended by their doctor do so without knowing the cost of that treatment. The price tag on most medical visits is so high for the uninsured, a full one-third of all money raised on GoFundMe is for health care costs.

A raft of legislation in nearly every state is set on tackling some of these endemic issues, with energy aimed squarely at lowering costs and expanding access. Some of this legislation is grand in scope, notably in states like New York where legislators are looking to put a public option on the table for residents there. Other states are taking a narrower approach, requiring providers to release price lists so patients are aware of what their care will cost.

Stacker analyzed cost data released on June 8, 2021, from the Centers for Medicare & Medicaid Services, common provider data from Verywell Health, and state zip codes from Simplemaps to find the average out-of-pocket cost for three typical medical visits in each state.

Montana

- Most common family practice visit costs
--- Medicare recipients: $104.87 for established patients ($90.90 for new patients)
--- Other insurance holders: $26.22 for established patients ($22.73 for new patients)
- Most common internal medicine visit costs
--- Medicare recipients: $104.87 for established patients ($135.79 for new patients)
--- Other insurance holders: $26.22 for established patients ($33.95 for new patients)
- Most common pediatric medicine visit costs
--- Medicare recipients: $104.87 for established patients ($90.90 for new patients)
--- Other insurance holders: $26.22 for established patients ($22.73 for new patients)

Montana lawmakers cut funding for Medicaid in 2021. Under new changes in the law, Medicaid recipients may not be able to keep their coverage for a full year regardless of potential changes in income. If a resident's income level increases, they may be required to find new insurance.

Some trends held steady across most states. For family practice and pediatric visits, new patients often pay less than established patients. For internal medicine visits, new patients frequently pay more than established patients. Both of these trends exist regardless of insurance type.

Transparency is increasingly paramount in American health care. Keep reading for a look at what common medical visits cost in neighboring states and the state-level factors that may influence these costs.

South Dakota

- Most common family practice visit costs
--- Medicare recipients: $102.41 for established patients ($88.26 for new patients)
--- Other insurance holders: $25.60 for established patients ($22.07 for new patients)
- Most common internal medicine visit costs
--- Medicare recipients: $102.41 for established patients ($131.75 for new patients)
--- Other insurance holders: $25.60 for established patients ($32.94 for new patients)
- Most common pediatric medicine visit costs
--- Medicare recipients: $102.41 for established patients ($88.26 for new patients)
--- Other insurance holders: $25.60 for established patients ($22.07 for new patients)

South Dakota is one of the 12 states that have declined to expand Medicaid access, and not everyone in the state is happy about it. A cohort of the state's health care systems has come together to lobby for a major expansion of Medicaid in the state, aiming to expand access and lower costs.

Wyoming

- Most common family practice visit costs
--- Medicare recipients: $104.34 for established patients ($90.34 for new patients)
--- Other insurance holders: $26.08 for established patients ($22.58 for new patients)
- Most common internal medicine visit costs
--- Medicare recipients: $104.34 for established patients ($134.92 for new patients)
--- Other insurance holders: $26.08 for established patients ($33.73 for new patients)
- Most common pediatric medicine visit costs
--- Medicare recipients: $104.34 for established patients ($90.34 for new patients)
--- Other insurance holders: $26.08 for established patients ($22.58 for new patients)

The Wyoming House of Representatives passed a Medicaid expansion bill in 2021 that allows people whose income is at or below 138% of the federal poverty level to access coverage, reaching those who don't qualify for Medicaid or premium subsidies under the Affordable Care Act.