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 |
|---|---|---|---|---|
| Excision breast lesion CPT 19125 | $850.40 | $1,063.00 | $11,217.60 – $11,217.60 | 1 |
| Excision floor mouth lesion 41116 CPT 41116 | $495.20 | $619.00 | $9,283.38 – $9,283.38 | 1 |
| Excision graft extremity CPT 35903 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Excision gum each quadrant CPT 41820 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision hand/finger tendon CPT 26415 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excision lesion mouth roof CPT 42106 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision lesion mouth roof CPT 42107 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excision nasal polyp(s) simple 30110 CPT 30110 | $372.00 | $465.00 | $4,529.52 – $4,529.52 | 1 |
| Excision of anal lesion(s) CPT 46922 | $474.40 | $593.00 | $8,384.23 – $8,384.23 | 1 |
| Excision of gum flap CPT 41821 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Excision of gum lesion CPT 41822 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Excision of gum lesion CPT 41823 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excision of gum lesion CPT 41826 | $453.60 | $567.00 | $9,283.38 – $9,283.38 | 1 |
| Excision of gum lesion CPT 41827 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excision of gum lesion CPT 41828 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Excision of gum lesion 41825 CPT 41825 | $325.60 | $407.00 | $9,283.38 – $9,283.38 | 1 |
| Excision of lingual tonsil CPT 42870 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Excision of meckels diverticulum 44800 CPT 44800 | $1,140.80 | $1,426.00 | not published | 0 |
| Excision of mouth lesion complex 40816 CPT 40816 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of neck cyst CPT 42815 | $808.00 | $1,010.00 | $17,423.47 – $17,423.47 | 1 |
| Excision of neck cyst confined 42810 CPT 42810 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of penis lesion(s) 54060 CPT 54060 | $293.60 | $367.00 | $5,631.53 – $5,631.53 | 1 |
| Excision of rectal lesion CPT 45160 | not published | not published | $8,384.23 – $8,384.23 | 1 |
| Excision of rectal stricture CPT 45150 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Excision of salivary cyst CPT 42408 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of tongue lesion CPT 41112 | $503.20 | $629.00 | $9,283.38 – $9,283.38 | 1 |
| Excision of tongue lesion CPT 41114 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of tongue lesion w/closure 41113 CPT 41113 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of tonsil tags CPT 42860 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of umbilicus 49250 CPT 49250 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Excision of uvula CPT 42140 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Excision of vaginal septum 57130 CPT 57130 | not published | not published | $9,225.99 – $9,225.99 | 1 |
| Excision olecranon bursa CPT 24105 | $533.60 | $667.00 | $9,712.92 – $9,712.92 | 1 |
| Excision radial head CPT 24130 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excision tongue lesion without closure 41110 CPT 41110 | $343.20 | $429.00 | $9,283.38 – $9,283.38 | 1 |
| Excision tumor soft tissue back/flank subcutaneous >= 3 cm CPT 21931 | $696.00 | $870.00 | $4,893.07 – $4,893.07 | 1 |
| Excis partial tal calc CPT 28120 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Excis uppr jaw cyst w/repair CPT 21049 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Exc leg/ankle tum dep 5 cm/ > 27634 CPT 27634 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc leg/ankle tum subfasc<5cm 27619 CPT 27619 | $679.20 | $849.00 | $8,429.22 – $8,429.22 | 1 |
| Exc les conjunctiva <1 cm CPT 68110 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Exc les conjunctiva >1 cm CPT 68115 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Exc les conjunctiva adj scl CPT 68130 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Exc les/mucos/sub/ves mouth/no rpr 40810 CPT 40810 | $322.40 | $403.00 | $9,283.38 – $9,283.38 | 1 |
| Exc malig feenl <0.5cm 11640 CPT 11640 | $301.60 | $377.00 | $2,117.62 – $2,117.62 | 1 |
| Exc malig feenl 1.1-2 11642 CPT 11642 | $395.20 | $494.00 | $2,117.62 – $2,117.62 | 1 |
| Exc malig feenl 3.1-4.0 11644 CPT 11644 | $572.00 | $715.00 | $4,893.07 – $4,893.07 | 1 |
| Exc malig feenl >4cm 11646 CPT 11646 | $744.00 | $930.00 | $8,429.22 – $8,429.22 | 1 |
| Exc malig snhfg 0.5cm or less 11620 CPT 11620 | $294.40 | $368.00 | $4,893.07 – $4,893.07 | 1 |
| Exc malig snhfg 0.6-1.0 cm 11621 CPT 11621 | $339.20 | $424.00 | $2,117.62 – $2,117.62 | 1 |
| Exc malig snhfg 2.1-3 cm 11623 CPT 11623 | $436.00 | $545.00 | $4,893.07 – $4,893.07 | 1 |
| Exc malig tal <0.5cm 11600 CPT 11600 | $293.60 | $367.00 | $2,117.62 – $2,117.62 | 1 |
| Exc malig tal 0.6-1.0cm 11601 CPT 11601 | $338.40 | $423.00 | $2,117.62 – $2,117.62 | 1 |
| Exc mal+marg tal 1.1-2 cm 11602 CPT 11602 | $360.80 | $451.00 | $1,217.32 – $1,217.32 | 1 |
| Exc mal+marg tal 2.1-3 cm 11603 CPT 11603 | $410.40 | $513.00 | $2,117.62 – $2,117.62 | 1 |
| Exc mal+marg tal 3.1-4 cm 11604 CPT 11604 | $457.60 | $572.00 | $2,117.62 – $2,117.62 | 1 |
| Exc mandible 21025 CPT 21025 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Exc neck tum deep < 5 cm CPT 21556 | $800.80 | $1,001.00 | $8,429.22 – $8,429.22 | 1 |
| Exc neck tum deep 5 cm/> CPT 21554 | $1,079.20 | $1,349.00 | $8,429.22 – $8,429.22 | 1 |
| Exc of facial bones/osteomy/abcess 21026 CPT 21026 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Exc of residual cervix via aginal approach 57550 CPT 57550 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Exc/pilonidal cyst/sinus/simple 11770 CPT 11770 | $542.40 | $678.00 | $8,429.22 – $8,429.22 | 1 |
| Exc prtl bn phlnx toe CPT 28124 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Exc rect tum transanal full CPT 45172 | not published | not published | $8,384.23 – $8,384.23 | 1 |
| Exc rect tum transanal part CPT 45171 | not published | not published | $8,384.23 – $8,384.23 | 1 |
| Exc sac pr ulc prim str ostc CPT 15933 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc sac pr ulc skn flp ostc CPT 15935 | $1,697.60 | $2,122.00 | $10,614.75 – $10,614.75 | 1 |
| Exc sacral pr ulc prim sutr CPT 15931 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc sacral pr ulc skn flap CPT 15934 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Exc shoulder tum deep < 5 cm CPT 23076 | $804.00 | $1,005.00 | $8,429.22 – $8,429.22 | 1 |
| Exc skn hdrdnt ax complex CPT 11451 | $783.20 | $979.00 | $8,429.22 – $8,429.22 | 1 |
| Exc skn hdrdnt ax smpl/ntrm CPT 11450 | $638.40 | $798.00 | $8,429.22 – $8,429.22 | 1 |
| Exc skn hdrdnt ing complex CPT 11463 | $783.20 | $979.00 | $8,429.22 – $8,429.22 | 1 |
| Exc snhfg mal+mrg 1.1-2 11622 CPT 11622 | $372.00 | $465.00 | $2,117.62 – $2,117.62 | 1 |
| Exc snhfg mal+mrg 3.1-4 11624 CPT 11624 | $496.80 | $621.00 | $4,893.07 – $4,893.07 | 1 |
| Exc snhfg mal+mrg >4 cm 11626 CPT 11626 | $600.80 | $751.00 | $8,429.22 – $8,429.22 | 1 |
| Exc sq tum/leg or ankle area <3 cm 27618 CPT 27618 | $720.80 | $901.00 | $4,893.07 – $4,893.07 | 1 |
| Exc sq tum/neck/ant thorax 3cm/> 21552 CPT 21552 | $661.60 | $827.00 | $8,429.22 – $8,429.22 | 1 |
| Exc sq tum/neck or ant thorax <3cm 21555 CPT 21555 | $648.80 | $811.00 | $4,893.07 – $4,893.07 | 1 |
| Exc sq tumor/foot or toe < 1.5 cm 28039 CPT 28039 | $721.60 | $902.00 | $8,429.22 – $8,429.22 | 1 |
| Exc sq tumor/forearm/wrist/<3cm 25075 CPT 25075 | $782.40 | $978.00 | $4,893.07 – $4,893.07 | 1 |
| Exc sq tumor/leg/ankle 3cm/> 27632 CPT 27632 | $621.60 | $777.00 | $8,429.22 – $8,429.22 | 1 |
| Exc sq tumor/shoulder area 3cm/> 23071 CPT 23071 | $622.40 | $778.00 | $4,893.07 – $4,893.07 | 1 |
| Exc sq tumor/thigh/knee area 3cm/> 27337 CPT 27337 | $621.60 | $777.00 | $8,429.22 – $8,429.22 | 1 |
| Exc sq tum/vasc malform/hand/fngr 26111 CPT 26111 | $612.80 | $766.00 | $4,893.07 – $4,893.07 | 1 |
| Exc subq tum/sft tis/pel/hip 3cm/> 27043 CPT 27043 | $694.40 | $868.00 | $8,429.22 – $8,429.22 | 1 |
| Exc tendon sheath or cap lesion 26160 CPT 26160 | $926.40 | $1,158.00 | $4,680.86 – $4,680.86 | 1 |
| Exc thigh/knee les sc<3cm 27327 CPT 27327 | $756.00 | $945.00 | $4,893.07 – $4,893.07 | 1 |
| Exc thigh/knee tum deep <5cm CPT 27328 | $945.60 | $1,182.00 | $8,429.22 – $8,429.22 | 1 |
| Exc thigh/knee tum dep 5cm/> CPT 27339 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc thrombosed hemorrhoid 46320 CPT 46320 | $320.80 | $401.00 | $3,533.55 – $3,533.55 | 1 |
| Exc tmr sft tiss shldr subq <3cm CPT 23075 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Exc torus mandibularis 21031 CPT 21031 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Exc trchntric pr ulcer w/prim sutr w/ostectomy 15951 CPT 15951 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Exc trchntr pr ulc flp clsr CPT 15952 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Exc trchntr pr ulc flp ostc CPT 15953 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Exc trchntr pr ulc prep flap CPT 15956 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Exc trchntr pr ulc prep ostc CPT 15958 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Exc trchntr pr ulc prim sutr CPT 15950 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Exc tr-ext mal+marg tal >4 cm 11606 CPT 11606 | $659.20 | $824.00 | $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.