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 |
|---|---|---|---|---|
| Exc back tum deep 5 cm/> CPT 21933 | $1,092.80 | $1,366.00 | $8,429.22 – $8,429.22 | 1 |
| Exc bartholins gland/cyst CPT 56740 | $470.40 | $588.00 | $9,225.99 – $9,225.99 | 1 |
| Exc benign feenlm 3.1-4.0cm 11444 CPT 11444 | $419.20 | $524.00 | $4,893.07 – $4,893.07 | 1 |
| Exc benign feenlm >4.0cm 11446 CPT 11446 | $569.60 | $712.00 | $8,429.22 – $8,429.22 | 1 |
| Exc benign snhfg 3.1-4.0cm 11424 CPT 11424 | $347.20 | $434.00 | $4,893.07 – $4,893.07 | 1 |
| Exc benign tal 0.5 < cm 11400 CPT 11400 | $189.60 | $237.00 | $2,117.62 – $2,117.62 | 1 |
| Exc ben+marg excep skin tag feenlm <0.5cm 11440 CPT 11440 | $212.80 | $266.00 | $2,117.62 – $2,117.62 | 1 |
| Exc ben+marg excep skin tag feenlm 1.1-2cm 11442 CPT 11442 | $286.40 | $358.00 | $2,117.62 – $2,117.62 | 1 |
| Exc ben+marg excep skin tag feenlm 2.1-3cm 11443 CPT 11443 | $336.80 | $421.00 | $4,893.07 – $4,893.07 | 1 |
| Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 CPT 11421 | $236.80 | $296.00 | $2,117.62 – $2,117.62 | 1 |
| Exc ben+marg excep skin tag snhfg 2.1-3cm 11423 CPT 11423 | $303.20 | $379.00 | $4,893.07 – $4,893.07 | 1 |
| Exc ben+marg excep skin tag snhfg >4cm 11426 CPT 11426 | $492.80 | $616.00 | $8,429.22 – $8,429.22 | 1 |
| Exc ben+marg excep skin tag tal 0.6-1cm 11401 CPT 11401 | $232.00 | $290.00 | $1,217.32 – $1,217.32 | 1 |
| Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 CPT 11403 | $763.20 | $954.00 | $2,117.62 – $2,117.62 | 1 |
| Exc breast duct fistula 19112 CPT 19112 | not published | not published | $11,217.60 – $11,217.60 | 1 |
| Exc cervix repair bowel 57556 CPT 57556 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Exc cervix/repair vagina 57555 CPT 57555 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Exc chest wall tumor w/ribs 21601 CPT 21601 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc coccygl pr ulc flap clsr CPT 15922 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Exc coccygl pr ulc prim sutr CPT 15920 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc constrict ring finger w/mlt z-plasties 26596 CPT 26596 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Exc/crtg b1 cst/b9 tum rds CPT 24120 | $819.20 | $1,024.00 | $9,712.92 – $9,712.92 | 1 |
| Exc/crtg b1 cst/tum hum agrf CPT 24115 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Exc/crtg b1 cst/tum hum algr CPT 24116 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Exc/crtg b1 cst/tum rds agrf CPT 24125 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Exc/crtg b1 cst/tum rds algr CPT 24126 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Exc/curetg cst/tum tarsal/metar w/iliac/agrf 28106 CPT 28106 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Exc/curtg b1 cst/b9 tum hum CPT 24110 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Exc excessive skin buttock CPT 15835 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc excessive skin hip CPT 15834 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc excessive skin leg CPT 15833 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc excessive skin thigh CPT 15832 | $1,398.40 | $1,748.00 | $8,429.22 – $8,429.22 | 1 |
| Exc excsv skin forearm/hand CPT 15837 | $1,305.60 | $1,632.00 | $8,429.22 – $8,429.22 | 1 |
| Exc excsv submental fat pad CPT 15838 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc ext ear/partial/simple repair 69110 CPT 69110 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc face tum deep < 2 cm CPT 21013 | $797.60 | $997.00 | $4,893.07 – $4,893.07 | 1 |
| Exc face tum deep 2cm/> 21014 CPT 21014 | $788.80 | $986.00 | $8,429.22 – $8,429.22 | 1 |
| Exc feenl mal+mrg 0.6-1 11641 CPT 11641 | $349.60 | $437.00 | $2,117.62 – $2,117.62 | 1 |
| Exc feenl mal+mrg 2.1-3 11643 CPT 11643 | $464.00 | $580.00 | $4,893.07 – $4,893.07 | 1 |
| Exc foot/toe tum dep 1.5cm/> CPT 28041 | $657.60 | $822.00 | $8,429.22 – $8,429.22 | 1 |
| Exc foot/toe tum subq < 1.5 cm 28043 CPT 28043 | $563.20 | $704.00 | $4,893.07 – $4,893.07 | 1 |
| Exc forearm les sc 3 cm/> CPT 25071 | $627.20 | $784.00 | $4,893.07 – $4,893.07 | 1 |
| Exc forearm tum deep < 3 cm CPT 25076 | $764.00 | $955.00 | $4,893.07 – $4,893.07 | 1 |
| Exc forearm tum deep 3 cm/> CPT 25073 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc hand les sc < 1.5 cm CPT 26115 | $822.40 | $1,028.00 | $4,893.07 – $4,893.07 | 1 |
| Exc hand tum deep 1.5 cm/> CPT 26113 | $805.60 | $1,007.00 | $4,893.07 – $4,893.07 | 1 |
| Exc hand tum deep < 1.5 cm 26116 CPT 26116 | $774.40 | $968.00 | $4,893.07 – $4,893.07 | 1 |
| Exchange biliary drg cath CPT 47536 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Exchange blood transfusion newborn 36450 CPT 36450 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Exchange drainage catheter CPT 49423 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Exchange lens prosthesis CPT 66986 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Exchange nephrostomy cath CPT 50435 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Exc hidradenitis ing simpl 11462 CPT 11462 | $632.00 | $790.00 | $8,429.22 – $8,429.22 | 1 |
| Exc hidradenitis peri/umb comp 11471 CPT 11471 | $808.00 | $1,010.00 | $8,429.22 – $8,429.22 | 1 |
| Exc hidradenitis peri/umb int 11470 CPT 11470 | $676.00 | $845.00 | $8,429.22 – $8,429.22 | 1 |
| Exc hip/pelv tum deep < 5 cm CPT 27048 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc hip/pelv tum deep 5 cm/> CPT 27045 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Excimer lsr psriasis 250-500 CPT 96921 | not published | not published | $589.25 – $589.25 | 1 |
| Excimer lsr psriasis<250sqcm CPT 96920 | not published | not published | $589.25 – $589.25 | 1 |
| Excimer lsr psriasis>500sqcm CPT 96922 | not published | not published | $1,217.32 – $1,217.32 | 1 |
| Exc im tumor/back/flank/ < 5 cm 21932 CPT 21932 | $980.80 | $1,226.00 | $8,429.22 – $8,429.22 | 1 |
| Exc im tumor/foot/toe < 1.5 cm 28045 CPT 28045 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc im tumor/shoulder area 5cm/> 23073 CPT 23073 | $1,055.20 | $1,319.00 | $8,429.22 – $8,429.22 | 1 |
| Exc ischial pr ulcer w/ostc musc/myoq flap/skin 15946 CPT 15946 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Exc ischial pr ulc prim sutr CPT 15940 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc isch pr ulc prm sut ostc CPT 15941 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc isch pr ulc skn flp clsr CPT 15944 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Exc isch pr ulc skn flp ostc CPT 15945 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Excise anal ext tag/papilla CPT 46220 | $378.40 | $473.00 | $3,533.55 – $3,533.55 | 1 |
| Excise epiphyseal bar CPT 20150 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excise foot tendon sheath CPT 28086 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excise foot tendon sheath CPT 28088 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excise inferior turbinate CPT 30130 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excise intraspinl lesion crv CPT 63265 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Excise intrspinl lesion lmbr CPT 63267 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Excise intrspinl lesion scrl CPT 63268 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Excise lesion testis CPT 54512 | $807.20 | $1,009.00 | $10,458.39 – $10,458.39 | 1 |
| Excise lip or cheek fold CPT 40819 | $398.40 | $498.00 | $4,529.52 – $4,529.52 | 1 |
| Excise lwr jaw cyst w/repair CPT 21047 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise mandible lesion CPT 21040 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excise max/zygoma b9 tumor CPT 21030 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise max/zygoma mal tumor CPT 21034 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise oral mucosa for graft 40818 CPT 40818 | not published | not published | $1,490.61 – $1,490.61 | 1 |
| Excise parotid gland/lesion CPT 42410 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise parotid gland/lesion CPT 42415 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise parotid gland/lesion CPT 42420 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise parotid gland/lesion CPT 42425 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise pharynx lesion CPT 42808 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excise/repair mouth lesion CPT 40812 | $411.20 | $514.00 | $4,529.52 – $4,529.52 | 1 |
| Excise sublingual gland CPT 42450 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excise submaxillary gland CPT 42440 | $627.20 | $784.00 | $17,423.47 – $17,423.47 | 1 |
| Excise subq tumor/abd wall <3 cm 22902 CPT 22902 | $708.00 | $885.00 | $4,893.07 – $4,893.07 | 1 |
| Excise tendon forearm/wrist CPT 25109 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excise wrist tendon sheath CPT 25118 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Excision addl breast lesion 19126 CPT 19126 | $5,816.00 | $7,270.00 | not published | 0 |
| Excision aural polyp CPT 69540 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Excision benign lesion face/ears/eyelids/nose/lips/muc memb 0.6 - 1.0 cm CPT 11441 | $258.40 | $323.00 | $2,117.62 – $2,117.62 | 1 |
| Excision benign lesion scalp/neck/hands/feet/genitalia 1.1 - 2.0 cm CPT 11422 | $265.60 | $332.00 | $4,893.07 – $4,893.07 | 1 |
| Excision benign lesion trunk/arms/legs 1.1 - 2.0 cm CPT 11402 | $763.20 | $954.00 | $2,117.62 – $2,117.62 | 1 |
| Excision benign lesion trunk/arms/legs > 4.0 cm CPT 11406 | $1,492.80 | $1,866.00 | $4,893.07 – $4,893.07 | 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.