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 |
|---|---|---|---|---|
| Dx laryngoscopy w/oper scope CPT 31526 | not published | not published | $5,216.13 – $5,216.13 | 1 |
| Dynamic cavernosometry CPT 54231 | not published | not published | $701.12 – $701.12 | 1 |
| Dynamic surface emg CPT 96002 | not published | not published | $474.53 – $474.53 | 1 |
| Ear and throat examination CPT 92502 | not published | not published | $1,490.61 – $1,490.61 | 1 |
| Ear canal biopsy 69105 CPT 69105 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Ear cartilage graft CPT 21235 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Ear irrigation 69209 CPT 69209 | $92.80 | $116.00 | $187.55 – $187.55 | 1 |
| Ear protector evaluation CPT 92596 | not published | not published | $110.81 – $110.81 | 1 |
| Ecallantide injection HCPCS J1290 | not published | not published | $1,304.97 – $1,790.42 | 2 |
| Ecg 12 lead tracing only CPT 93005 | $127.20 | $159.00 | $187.55 – $187.55 | 1 |
| Ecg/1-3 leads/interp & report only 93042 CPT 93042 | $10.40 | $13.00 | not published | 0 |
| Ecg/1-3 leads/tracing only 93041 CPT 93041 | not published | not published | $187.55 – $187.55 | 1 |
| Ecg < 30 days transmission & analysis CPT 93271 | not published | not published | $325.68 – $325.68 | 1 |
| Ecg external < 48 hours recording CPT 93225 | $145.60 | $182.00 | $378.88 – $378.88 | 1 |
| Ecg external < 48 hours scanning analysis w/report CPT 93226 | $267.20 | $334.00 | $378.88 – $378.88 | 1 |
| Ecg external > 48 hours up to 7 days recording CPT 93242 | $78.40 | $98.00 | $110.81 – $110.81 | 1 |
| Ecg external >7 days up to 15 days recording CPT 93246 | $127.20 | $159.00 | $187.55 – $187.55 | 1 |
| Echocardiogram (Heart Ultrasound) CPT 93306 | $1,164.00 | $1,455.00 | $1,641.72 – $1,641.72 | 1 |
| Echocardiography doppler color flow mapping CPT 93325 | $410.40 | $513.00 | not published | 0 |
| Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler HCPCS C8929 | $1,011.20 | $1,264.00 | $2,417.07 – $2,417.07 | 1 |
| Echocardiography transthoracic 2d followup/limited CPT 93308 | $318.40 | $398.00 | $761.98 – $761.98 | 1 |
| Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast HCPCS C8924 | $656.80 | $821.00 | $1,202.18 – $1,202.18 | 1 |
| Echocardiograpy doppler follow up/limited study CPT 93321 | $509.60 | $637.00 | not published | 0 |
| Echo exam of eye CPT 76516 | not published | not published | $348.75 – $348.75 | 1 |
| Echo exam of eye CPT 76519 | not published | not published | $348.75 – $348.75 | 1 |
| Echo exam of eye CPT 76529 | not published | not published | $283.48 – $283.48 | 1 |
| Echo exam of eye thickness CPT 76514 | not published | not published | $81.43 – $81.43 | 1 |
| Echo exam of fetal heart CPT 76825 | $842.40 | $1,053.00 | $1,641.72 – $1,641.72 | 1 |
| Echo exam of fetal heart CPT 76826 | not published | not published | $761.98 – $761.98 | 1 |
| Echo exam of fetal heart CPT 76827 | not published | not published | $348.75 – $348.75 | 1 |
| Echo exam of fetal heart CPT 76828 | not published | not published | $348.75 – $348.75 | 1 |
| Echo exam uterus 76831- CPT 76831 | $381.60 | $477.00 | $761.98 – $761.98 | 1 |
| Echograp trans r pros study CPT 76873 | not published | not published | $348.75 – $348.75 | 1 |
| Echo guide for amniocentesis CPT 76946 | $327.20 | $409.00 | not published | 0 |
| Echo guide for artery repair CPT 76936 | $922.40 | $1,153.00 | $913.84 – $913.84 | 1 |
| Echo stress CPT 93350 | $646.40 | $808.00 | $1,641.72 – $1,641.72 | 1 |
| Echo tee cngntl wo ctrst probe plcmnt CPT 93316 | not published | not published | $1,641.72 – $1,641.72 | 1 |
| Echo tee guidance CPT 93355 | $1,392.80 | $1,741.00 | not published | 0 |
| Echo tee probe placement image acquisition interpretation & report CPT 93312 | $772.00 | $965.00 | $1,641.72 – $1,641.72 | 1 |
| Echo transesophageal CPT 93313 | not published | not published | $1,641.72 – $1,641.72 | 1 |
| Echo transesophageal CPT 93315 | not published | not published | $1,641.72 – $1,641.72 | 1 |
| Echo transesophageal intraop CPT 93318 | not published | not published | $1,641.72 – $1,641.72 | 1 |
| Echo transthoracic CPT 93303 | $508.80 | $636.00 | $1,641.72 – $1,641.72 | 1 |
| Echo transthoracic CPT 93304 | not published | not published | $1,641.72 – $1,641.72 | 1 |
| Echo tte 2d comp wo ctrst wo clr/dplr CPT 93307 | $556.80 | $696.00 | $761.98 – $761.98 | 1 |
| Ecog impltd brn npgt <30 d CPT 95836 | not published | not published | $114.22 – $114.22 | 1 |
| E coli 0157 ag ia CPT 87335 | not published | not published | $15.83 – $39.08 | 2 |
| Ecp ciliary body destruction CPT 66711 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Eculizumab 300 mg/30 ml intravenous solution HCPCS J1299 | not published | not published | $100.73 – $138.21 | 2 |
| Edetate calcium disodium inj HCPCS J0600 | not published | not published | $14,522.78 – $19,925.25 | 2 |
| Edu/train/pt/nonmd/in person/30 min98960 CPT 98960 | $47.20 | $59.00 | not published | 0 |
| Eeg 41-60 minutes 95812-26 CPT 95812 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg/cerebral death evaluation only 95824 -26 CPT 95824 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Eeg monitoring/function test CPT 95958 | not published | not published | $3,048.91 – $3,048.91 | 1 |
| Eeg monitoring/giving drugs CPT 95954 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Eeg monitor/record/awake/drowsy 95816 CPT 95816 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg over 1 hour 95813 - 26 CPT 95813 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg/record in coma or sleep only 95822 CPT 95822 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg recording awake and asleep CPT 95819 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg without vid 2-12hr cont mntr CPT 95707 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg without vid 2-12 hr unmntr CPT 95705 | not published | not published | $474.53 – $474.53 | 1 |
| Eeg without vid ea 12-26hr cont CPT 95710 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Eeg without vid ea 12-26hr intmt CPT 95709 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Eeg wo vid 2-12hr intmt mntr CPT 95706 | not published | not published | $913.84 – $913.84 | 1 |
| Eeg wo vid ea 12-26hr unmntr CPT 95708 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| E equine encephalitis igg CPT 86652 | not published | not published | $16.49 – $40.72 | 2 |
| Efgartigimod alfa-fcab 20 mg/ml intravenous solution HCPCS J9332 | not published | not published | $72.89 – $100.01 | 2 |
| Egd balloon dil esoph30 mm/> CPT 43233 | $334.40 | $418.00 | $5,682.83 – $5,682.83 | 1 |
| Egd control bleeding any CPT 43255 | $966.40 | $1,208.00 | $5,682.83 – $5,682.83 | 1 |
| Egd dilate stricture CPT 43245 | $917.60 | $1,147.00 | $5,682.83 – $5,682.83 | 1 |
| Egd endo mucosal resection CPT 43254 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd endoscopic stent place CPT 43266 | not published | not published | $17,100.59 – $17,100.59 | 1 |
| Egd esophagogastrc fndoplsty CPT 43210 | $629.60 | $787.00 | $29,652.07 – $29,652.07 | 1 |
| Egd flx trnsorl dplmnt balo CPT 43290 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd flx trnsorl rmvl balo CPT 43291 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Egd guide wire insertion CPT 43248 | $631.20 | $789.00 | $2,693.66 – $2,693.66 | 1 |
| Egd injection varices CPT 43243 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd/insert intraluminal tube/cath 43241 CPT 43241 | $207.20 | $259.00 | $5,682.83 – $5,682.83 | 1 |
| Egd lesion ablation CPT 43270 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd optical endomicroscopy CPT 43252 | not published | not published | $10,639.72 – $10,639.72 | 1 |
| Egd remove foreign body CPT 43247 | $583.20 | $729.00 | $2,693.66 – $2,693.66 | 1 |
| Egd remove lesion snare CPT 43251 | $760.00 | $950.00 | $5,682.83 – $5,682.83 | 1 |
| Egd/remov tum/polyp/hot bx forcep 43250 CPT 43250 | $693.60 | $867.00 | $5,682.83 – $5,682.83 | 1 |
| Egd Ultrasound exam duodenum/jejunum CPT 43259 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd Ultrasound fine needle bx/aspir CPT 43238 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd Ultrasound fine needle bx/aspir CPT 43242 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd Ultrasound transmural injxn/mark CPT 43253 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd varices ligation CPT 43244 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Egd w/thrml txmnt gerd CPT 43257 | not published | not published | $10,639.72 – $10,639.72 | 1 |
| Egd w/transmural drain cyst CPT 43240 | not published | not published | $17,100.59 – $17,100.59 | 1 |
| Egfr gene com variants CPT 81235 | $1,009.60 | $1,262.00 | $405.73 – $1,001.98 | 2 |
| Ehrlicha chaffeensis amp prb CPT 87484 | not published | not published | $43.86 – $108.32 | 2 |
| EKG (Electrocardiogram) CPT 93000 | $21.60 | $27.00 | not published | 0 |
| EKG interpret & report preve g0405 HCPCS G0405 | $12.00 | $15.00 | not published | 0 |
| EKG tracing for initial prev HCPCS G0404 | $127.20 | $159.00 | $81.43 – $81.43 | 1 |
| Elbow arthroscopy CPT 29830 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Elbow arthroscopy/surgery CPT 29834 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Elbow arthroscopy/surgery CPT 29835 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Elbow arthroscopy/surgery CPT 29836 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Elbow arthroscopy/surgery CPT 29837 | not published | not published | $9,712.92 – $9,712.92 | 1 |
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.