Providence St Joseph Medical Center
6 13th Ave E, Polson, MT · Providence · · NPI 1821184888
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Change gastric port open CPT 43888 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Change g-tube to g-j perc CPT 49446 | $1,160.80 | $1,451.00 | $5,682.83 – $5,682.83 | 1 |
| Change nephroureteral cath CPT 50387 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Change of ureter tube/stent CPT 50688 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Change of windpipe airway 31502 CPT 31502 | not published | not published | $678.14 – $678.14 | 1 |
| Change stent via transureth CPT 50385 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Change ureter stent percut CPT 50382 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Chct for mal hyperthermia CPT 89049 | not published | not published | $513.12 – $513.12 | 1 |
| Chemical exfoliation acne 17360 CPT 17360 | not published | not published | $589.25 – $589.25 | 1 |
| Chemical peel face epiderm 15788 CPT 15788 | $578.40 | $723.00 | $1,217.32 – $1,217.32 | 1 |
| Chemical peel nonfacial 15793 CPT 15793 | $712.00 | $890.00 | $1,217.32 – $1,217.32 | 1 |
| Chemical peel nonfacial; epidermal CPT 15792 | $496.80 | $621.00 | $1,895.66 – $1,895.66 | 1 |
| Chemo adm cns w/lmbr punct CPT 96450 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Chemodener muscle larynx emg CPT 64617 | not published | not published | $2,102.48 – $2,102.48 | 1 |
| Chemodenerv 1 extrem 1-4 ea 64643 CPT 64643 | $140.00 | $175.00 | not published | 0 |
| Chemodenerv 1 extrem 5/> ea 64645 CPT 64645 | $180.80 | $226.00 | not published | 0 |
| Chemodenerv 1 extrem 5/> mus 64644 CPT 64644 | $266.40 | $333.00 | $2,102.48 – $2,102.48 | 1 |
| Chemodenerv 1 extremity 1-4 64642 CPT 64642 | $230.40 | $288.00 | $2,102.48 – $2,102.48 | 1 |
| Chemodenervation anal musc CPT 46505 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Chemodenervation/face muscl/unilat 64612 CPT 64612 | $200.00 | $250.00 | $887.20 – $887.20 | 1 |
| Chemodenervation nerve of eye muscle 67345 CPT 67345 | not published | not published | $863.77 – $863.77 | 1 |
| Chemodenerv eccrine glands CPT 64653 | $152.80 | $191.00 | $887.20 – $887.20 | 1 |
| Chemodenerv eccrine glands 64650 CPT 64650 | not published | not published | $887.20 – $887.20 | 1 |
| Chemodenerv musc migraine 64615 CPT 64615 | $228.80 | $286.00 | $887.20 – $887.20 | 1 |
| Chemodenerv musc neck dyston 64616 CPT 64616 | $208.00 | $260.00 | $887.20 – $887.20 | 1 |
| Chemodenerv saliv glands bilat 64611 CPT 64611 | $198.40 | $248.00 | $887.20 – $887.20 | 1 |
| Chemodenerv trunk musc 1-5 64646 CPT 64646 | not published | not published | $2,102.48 – $2,102.48 | 1 |
| Chemodenerv trunk musc 6/] 64647 CPT 64647 | $272.00 | $340.00 | $2,102.48 – $2,102.48 | 1 |
| Chemo extend IV infus w/pump HCPCS G0498 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Chemo ia infuse each addl hr CPT 96423 | not published | not published | $138.26 – $138.26 | 1 |
| Chemo ia infusion up to 1 hr CPT 96422 | not published | not published | $674.04 – $674.04 | 1 |
| Chemo ia push tecnique CPT 96420 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Chemo intralesional over 7 CPT 96406 | not published | not published | $674.04 – $674.04 | 1 |
| Chemo intralesional up to 7 96405 CPT 96405 | not published | not published | $220.15 – $220.15 | 1 |
| Chemotaxis assay CPT 86155 | not published | not published | $19.99 – $49.36 | 2 |
| Chemotherapy injection 96542 CPT 96542 | not published | not published | $674.04 – $674.04 | 1 |
| Chemotx admn pertl cav impl CPT 96446 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Chest 2 vws w oblique CPT 71048 | $392.00 | $490.00 | $348.75 – $348.75 | 1 |
| Chest apical lordotic proj CPT 71047 | $288.80 | $361.00 | $283.48 – $283.48 | 1 |
| Chest CT scan (with and without contrast) CPT 71270 | $1,961.60 | $2,452.00 | $588.44 – $588.44 | 1 |
| Chest CT scan (with contrast) CPT 71260 | $1,621.60 | $2,027.00 | $588.44 – $588.44 | 1 |
| Chest CT scan (without contrast) CPT 71250 | $1,380.00 | $1,725.00 | $348.75 – $348.75 | 1 |
| Chest X-ray CPT 71046 | $231.20 | $289.00 | $283.48 – $283.48 | 1 |
| Chest X-ray (single view) CPT 71045 | $183.20 | $229.00 | $283.48 – $283.48 | 1 |
| Chg pr pul rehab for copd patients CPT 94626 | $78.40 | $98.00 | $187.55 – $187.55 | 1 |
| Chg radiologic exam esophagus double contrast CPT 74221 | $437.60 | $547.00 | $588.44 – $588.44 | 1 |
| Chimerism anal no cell selec CPT 81267 | not published | not published | $259.33 – $640.43 | 2 |
| Chimerism anal w/cell select CPT 81268 | not published | not published | $325.99 – $805.06 | 2 |
| Chlamydia culture CPT 87110 | $148.80 | $186.00 | $24.50 – $60.51 | 2 |
| Chlamydia trachomatis ag if CPT 87270 | $88.00 | $110.00 | $14.98 – $36.98 | 2 |
| Chlamydia type CPT 87140 | $148.80 | $186.00 | $6.96 – $17.19 | 2 |
| Chloride CPT 82435 | $35.20 | $44.00 | $5.75 – $14.20 | 2 |
| Chloride 24 hour urine CPT 82436 | $72.80 | $91.00 | $7.19 – $17.75 | 2 |
| Chloroprocaine hcl injection HCPCS J2401 | $83.31 | $104.14 | $0.09 – $0.12 | 2 |
| Chloroprocaine opht gel, 1mg HCPCS J2403 | not published | not published | $1.35 – $1.85 | 2 |
| Chlorothiazide sodium 500 mg intravenous solution HCPCS J1205 | not published | not published | $90.86 – $124.66 | 2 |
| Chlorpromazine 0.125 mg/ml IV syringe - cnr HCPCS J3230 | $162.19 | $202.74 | $60.91 – $83.57 | 2 |
| Chmotx admn plrl cav thrcnts CPT 96440 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Cholangiogram percutaneous compl CPT 47532 | $5,757.60 | $7,197.00 | $11,557.38 – $11,557.38 | 1 |
| Cholangiography and/or pancreatography intraoperative supervision & interpretation CPT 74300 | $497.60 | $622.00 | not published | 0 |
| Cholecystectomy w/cholangiography 47605 CPT 47605 | $1,672.00 | $2,090.00 | not published | 0 |
| Cholecystostomy complete w/supervision & interpretation CPT 47490 | $4,604.80 | $5,756.00 | $11,557.38 – $11,557.38 | 1 |
| Cholesterol CPT 82465 | $35.20 | $44.00 | $5.44 – $13.43 | 2 |
| Cholesterol body fluid CPT 84999 | $92.80 | $116.00 | not published | 0 |
| Cholesterol (Lipid) Test CPT 80061 | $90.40 | $113.00 | $16.74 – $41.33 | 2 |
| Cholinesterase CPT 82480 | $122.40 | $153.00 | $9.84 – $24.29 | 2 |
| Cholinesterase challenge CPT 95857 | not published | not published | $913.84 – $913.84 | 1 |
| Chorion biopsy CPT 59015 | not published | not published | $2,295.45 – $2,295.45 | 1 |
| Chorionic gonadotropin/1000u HCPCS J0725 | $9.60 | $12.00 | $39.40 – $54.06 | 2 |
| Chrom analysis CPT 88273 | $115.20 | $144.00 | $43.51 – $107.46 | 2 |
| Chromatogram assay sugars CPT 84375 | not published | not published | $48.75 – $120.39 | 2 |
| Chromatography CPT 83021 | $198.40 | $248.00 | $22.58 – $55.75 | 2 |
| Chromogenic substrate assay CPT 85130 | not published | not published | $14.86 – $36.70 | 2 |
| Chromo high res and frag x - sendout CPT 81243 | $264.00 | $330.00 | $71.30 – $176.08 | 2 |
| Chromosome analys amniotic CPT 88269 | $750.40 | $938.00 | $217.08 – $536.09 | 2 |
| Chromosome analysis 100 CPT 88249 | not published | not published | $216.46 – $534.58 | 2 |
| Chromosome analysis 15-20 cell count CPT 88262 | $562.40 | $703.00 | $156.86 – $387.39 | 2 |
| Chromosome analysis 20-25 CPT 88245 | not published | not published | $216.46 – $534.58 | 2 |
| Chromosome analysis 45 CPT 88263 | not published | not published | $187.86 – $463.95 | 2 |
| Chromosome analysis 5 CPT 88261 | $796.80 | $996.00 | $330.43 – $816.02 | 2 |
| Chromosome analysis 50-100 CPT 88248 | not published | not published | $216.46 – $534.58 | 2 |
| Chromosome analys placenta CPT 88267 | not published | not published | $235.71 – $582.12 | 2 |
| Chromosome banding study CPT 88283 | not published | not published | $85.75 – $211.77 | 2 |
| Chromosome count additional CPT 88285 | $86.40 | $108.00 | $33.64 – $83.07 | 2 |
| Chromosome karyotype study CPT 88280 | $214.40 | $268.00 | $41.84 – $103.32 | 2 |
| Chromosome study additional CPT 88289 | not published | not published | $43.04 – $106.29 | 2 |
| Chronic urticaria - sendout CPT 86343 | not published | not published | $15.58 – $38.46 | 2 |
| Chylomicron screen, bf - sendout CPT 82664 | not published | not published | $76.88 – $189.85 | 2 |
| Cidofovir injection HCPCS J0740 | not published | not published | $1,191.09 – $1,634.18 | 2 |
| Cilastatin sodium injection HCPCS J0743 | not published | not published | $15.69 – $21.53 | 2 |
| Ciliary transsleral therapy CPT 66710 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Ciltacabtagene car-pos t HCPCS Q2056 | not published | not published | $1,245,102.37 – $1,708,280.45 | 2 |
| Cine/video x-rays CPT 76120 | not published | not published | $348.75 – $348.75 | 1 |
| Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback HCPCS J0744 | $45.56 | $56.95 | $5.22 – $7.16 | 2 |
| Circum 28 days or older CPT 54161 | $287.20 | $359.00 | $6,052.50 – $6,052.50 | 1 |
| Circumcise/surg/28 days or < 54160 CPT 54160 | $324.00 | $405.00 | $2,040.48 – $2,040.48 | 1 |
| Circumcision (newborn) CPT 54150 | $240.00 | $300.00 | $6,052.50 – $6,052.50 | 1 |
| Cisplatin 1 mg/ml desensitization HCPCS J9060 | $123.09 | $153.86 | $4.38 – $6.01 | 2 |
| C-kit mutation liquid tumor - sendout CPT 81272 | $1,009.60 | $1,262.00 | $411.89 – $1,017.20 | 2 |
| Cladribine 10 mg/10 ml intravenous solution HCPCS J9065 | not published | not published | $21.88 – $30.02 | 2 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.