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 |
|---|---|---|---|---|
| Fallopian tube recnl CPT 58345 | $428.80 | $536.00 | $9,225.99 – $9,225.99 | 1 |
| Family therapy without pt 50min 90846 CPT 90846 | $141.60 | $177.00 | $475.42 – $475.42 | 1 |
| Family therapy with patient 50 min 90847 CPT 90847 | $158.40 | $198.00 | $475.42 – $475.42 | 1 |
| Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr HCPCS J1308 | $65.96 | $82.45 | $0.02 – $0.03 | 2 |
| Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution HCPCS J9358 | $4,053.77 | $5,067.21 | $67.50 – $92.62 | 2 |
| Fancc gene CPT 81242 | not published | not published | $45.78 – $113.05 | 2 |
| Fat/lipids feces qualitative CPT 82705 | $67.20 | $84.00 | $6.38 – $15.74 | 2 |
| Fatty acids nonesterified CPT 82725 | not published | not published | $23.46 – $57.94 | 2 |
| Fecal bilirubin test CPT 82252 | not published | not published | $5.70 – $14.08 | 2 |
| Fecal microbiota, live-jslm 150 ml rectal suspension enema HCPCS J1440 | not published | not published | $144.07 – $197.66 | 2 |
| Fecal microbiota prep instil HCPCS G0455 | not published | not published | $2,711.70 – $2,711.70 | 1 |
| #fecal-sodium CPT 84302 | $41.60 | $52.00 | $6.08 – $15.00 | 2 |
| Felbamate (felbatol(r)) - sendout CPT 80167 | $72.00 | $90.00 | $23.30 – $57.54 | 2 |
| Fem/popl revasc w/stent CPT 37226 | not published | not published | $34,638.00 – $34,638.00 | 1 |
| Feno poc CPT 95012 | $28.00 | $35.00 | $110.81 – $110.81 | 1 |
| Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper) HCPCS J3010 | $188.98 | $236.23 | $2.17 – $2.98 | 2 |
| Fern test HCPCS Q0114 | not published | not published | $12.18 – $30.07 | 2 |
| Ferric carboxymaltose 50 mg iron/ml intravenous solution HCPCS J1439 | $2,792.20 | $3,490.25 | $2.57 – $3.53 | 2 |
| Ferritin CPT 82728 | $92.80 | $116.00 | $17.04 – $42.08 | 2 |
| Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution HCPCS Q0138 | $486.88 | $608.60 | $0.69 – $0.95 | 2 |
| Ferumoxytol, esrd use HCPCS Q0139 | not published | not published | $0.69 – $0.95 | 2 |
| Fetal biophys profile w/nst 76818 CPT 76818 | $466.40 | $583.00 | $348.75 – $348.75 | 1 |
| Fetal chrom aneuploidy gsa panel CPT 81420 | not published | not published | $948.81 – $2,343.19 | 2 |
| Fetal contract stress test 59020 - 26 CPT 59020 | $106.40 | $133.00 | $581.24 – $581.24 | 1 |
| Fetal cord puncture prenatal CPT 59012 | not published | not published | $952.66 – $952.66 | 1 |
| Fetal fibronectin CPT 82731 | $220.00 | $275.00 | $80.51 – $198.83 | 2 |
| Fetal fluid drainage w/us CPT 59074 | not published | not published | $952.66 – $952.66 | 1 |
| Fetal hemoglobin (kleihauer betke) CPT 85460 | $177.60 | $222.00 | $9.66 – $23.86 | 2 |
| Fetal hemoglobin rosette CPT 85461 | not published | not published | $11.70 – $28.89 | 2 |
| Fetal lung maturity assess lam body dnst CPT 83664 | not published | not published | $24.15 – $59.64 | 2 |
| Fetal non stress test CPT 59025 | $131.20 | $164.00 | $581.24 – $581.24 | 1 |
| Fetal scalp blood sampling 59030 CPT 59030 | not published | not published | $952.66 – $952.66 | 1 |
| Fetal shunt placement w/us CPT 59076 | not published | not published | $952.66 – $952.66 | 1 |
| #_fet/norfentcnfrmur CPT 80354 | $63.20 | $79.00 | not published | 0 |
| Fiasp for insulin pump use HCPCS J1811 | not published | not published | $17.46 – $23.96 | 2 |
| Fibrin degradation d dimer quantitative CPT 85379 | $168.00 | $210.00 | $12.73 – $31.43 | 2 |
| Fibrin degradation products CPT 85362 | $75.20 | $94.00 | $8.61 – $21.27 | 2 |
| Fibrin degrade semiquant CPT 85378 | $28.80 | $36.00 | $12.15 – $30.01 | 2 |
| Fibrinogen activity CPT 85384 | $122.40 | $153.00 | $12.15 – $30.01 | 2 |
| Fibrinolysins/coagulopathy screen interpretation/report CPT 85390 | not published | not published | $19.35 – $47.79 | 2 |
| Fibrinolytic antiplasmin CPT 85410 | $236.00 | $295.00 | $9.64 – $23.80 | 2 |
| Fibrinolytic plasminogen CPT 85415 | not published | not published | $21.49 – $53.07 | 2 |
| Fibrinolytic plasminogen xcpt antgnc asa CPT 85420 | $152.80 | $191.00 | $8.16 – $20.16 | 2 |
| Filgrastim-aafi 300 mcg/0.5 ml subcutaneous syringe HCPCS Q5110 | not published | not published | $0.64 – $0.88 | 2 |
| Filgrastim in d5w IV syringe 20 mcg/ml (neo) - cnr HCPCS J1442 | not published | not published | $2.22 – $3.04 | 2 |
| Filgrastim-sndz 300 mcg/0.5 ml injection syringe HCPCS Q5101 | not published | not published | $0.83 – $1.13 | 2 |
| Filleted finger/toe flap CPT 14350 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Filtered speech hearing test CPT 92571 | not published | not published | $110.81 – $110.81 | 1 |
| Fine needle aspiration biopsy w/fluor gdn;1st lesion 10007 CPT 10007 | $451.20 | $564.00 | $2,117.62 – $2,117.62 | 1 |
| Fine needle aspiration biopsy w/fluor gdn; ea addtl 10008 CPT 10008 | $211.20 | $264.00 | not published | 0 |
| Fine needle aspiration biopsy w/us gdn; ea addtl 10006 CPT 10006 | $89.60 | $112.00 | not published | 0 |
| Fine needle asp without image guide 10021 CPT 10021 | $150.40 | $188.00 | $1,217.32 – $1,217.32 | 1 |
| Finger tendon transfer CPT 26497 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Finger tendon transfer CPT 26498 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fit aphakia spectcl monofocl CPT 92352 | not published | not published | $187.55 – $187.55 | 1 |
| Fit aphakia spectcl multifoc CPT 92353 | not published | not published | $187.55 – $187.55 | 1 |
| Fitg spect low vis 1system CPT 92354 | not published | not published | $110.81 – $110.81 | 1 |
| Fitg spect lw vis cmpnd lens CPT 92355 | not published | not published | $110.81 – $110.81 | 1 |
| Fitting of diaphragm/cap 57170 CPT 57170 | $116.80 | $146.00 | $581.24 – $581.24 | 1 |
| Fixation of ankle joint CPT 27860 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fixation of knee joint CPT 27570 | $2,251.20 | $2,814.00 | $4,680.86 – $4,680.86 | 1 |
| Fixation of shoulder blade CPT 23400 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fix g/colon tube w/device CPT 49460 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Fixtn pq skel dstl rad fx/epiphysl sep CPT 25606 | $988.00 | $1,235.00 | $9,712.92 – $9,712.92 | 1 |
| Flecainide (tambocor)-sendout CPT 80181 | $27.20 | $34.00 | $23.30 – $57.54 | 2 |
| Fl exam g/colon tube w contrast CPT 49465 | $468.80 | $586.00 | $761.98 – $761.98 | 1 |
| Flexible Sigmoidoscopy CPT 45330 | $281.60 | $352.00 | $2,711.70 – $2,711.70 | 1 |
| Flexor-plasty elbow CPT 24330 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Flexor-plasty elbw w/advmnt CPT 24331 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Floor of mouth biopsy 41108 CPT 41108 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Flow cytometry interp 16 or more CPT 88189 | $60.00 | $75.00 | not published | 0 |
| Flow cytometry marker each additional CPT 88185 | $40.80 | $51.00 | not published | 0 |
| Flow cytometry one marker technical component CPT 88184 | $265.60 | $332.00 | $1,057.58 – $1,057.58 | 1 |
| Floxuridine injection HCPCS J9200 | not published | not published | $9,282.49 – $12,735.57 | 2 |
| Flt3 gene CPT 81245 | not published | not published | $206.89 – $510.93 | 2 |
| Flt3 gene analysis CPT 81246 | not published | not published | $103.75 – $256.22 | 2 |
| Fluconazole 200 mg/100 ml in sod. chloride (iso) intravenous piggyback HCPCS J1450 | $79.34 | $99.17 | $5.08 – $6.96 | 2 |
| Fludarabine 50 mg intravenous solution HCPCS J9185 | not published | not published | $161.21 – $221.18 | 2 |
| Fluidotherapy charges pt CPT 97022 | $24.00 | $30.00 | not published | 0 |
| Fluid pressure muscle 20950 CPT 20950 | not published | not published | $2,117.62 – $2,117.62 | 1 |
| Fluocinol acet intravit imp HCPCS J7313 | not published | not published | $1,120.04 – $1,536.70 | 2 |
| Fluocinolone acetonide implt HCPCS J7311 | not published | not published | $764.47 – $1,048.85 | 2 |
| Fluorescein angioscopy i&r CPT 92230 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Fluorescein angrph mltiframe CPT 92235 | not published | not published | $913.84 – $913.84 | 1 |
| Fluorescein&icg angiography CPT 92242 | not published | not published | $913.84 – $913.84 | 1 |
| Fluorescent antibody titer dna CPT 86256 | $120.00 | $150.00 | $15.06 – $37.20 | 2 |
| Fluoroguide for spine inject 77003-26 CPT 77003 | $390.40 | $488.00 | not published | 0 |
| Fluoroguide needle placement CPT 77002 | $484.00 | $605.00 | not published | 0 |
| Fluoro polarize fetal lung CPT 83663 | not published | not published | $23.64 – $58.38 | 2 |
| Fluoroscopy up to 1 hour CPT 76000 | $452.80 | $566.00 | $761.98 – $761.98 | 1 |
| Fluorouracil 50 mg/ml intravenous solution (wrapper) HCPCS J9190 | $55.08 | $68.85 | $3.86 – $5.29 | 2 |
| Fluphenazine decanoate 25 mg/ml injection solution HCPCS J2680 | not published | not published | $16.95 – $23.25 | 2 |
| Fmri brain by phys/psych CPT 70555 | not published | not published | $761.98 – $761.98 | 1 |
| Fmri brain by tech CPT 70554 | not published | not published | $761.98 – $761.98 | 1 |
| Fna bx w/ct gdn 1st les CPT 10009 | $622.40 | $778.00 | $2,117.62 – $2,117.62 | 1 |
| Fna bx w/ct gdn ea addl CPT 10010 | $349.60 | $437.00 | not published | 0 |
| Fna bx w/mr gdn 1st les CPT 10011 | not published | not published | $2,117.62 – $2,117.62 | 1 |
| Foam stability fetal lung CPT 83662 | not published | not published | $23.64 – $58.38 | 2 |
| Folic acid CPT 82746 | $80.00 | $100.00 | $18.38 – $45.38 | 2 |
| Folic acid 5 mg/ml injection solution HCPCS J1808 | $66.50 | $83.12 | $0.13 – $0.18 | 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.