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 |
|---|---|---|---|---|
| Follow-up angiography CPT 75898 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Followup eval of foot pt lop HCPCS G0246 | $57.60 | $72.00 | $394.38 – $394.38 | 1 |
| Follow-up surgery of eye CPT 66250 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Fomepizole 1 gram/ml intravenous solution HCPCS J1451 | $1,536.86 | $1,921.07 | not published | 0 |
| Fondaparinux sodium HCPCS J1652 | not published | not published | $1.62 – $2.22 | 2 |
| Foot X-ray CPT 73630 | $236.00 | $295.00 | $283.48 – $283.48 | 1 |
| Forehead flap w/vasc pedicle 15731 CPT 15731 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Forensic cytopathology CPT 88125 | not published | not published | $163.59 – $163.59 | 1 |
| Foreskn manip w/lss preputial ads+stretching 54450 CPT 54450 | $99.20 | $124.00 | $701.12 – $701.12 | 1 |
| Fosaprepitant 150 mg intravenous powder for solution HCPCS J1453 | $224.70 | $280.87 | $0.26 – $0.35 | 2 |
| Foscarnet sodium injection HCPCS J1455 | not published | not published | $35.06 – $48.11 | 2 |
| Fosphenytoin 50 mg pe/ml injection (wrapper) HCPCS Q2009 | $75.26 | $94.07 | not published | 0 |
| Fractionation ketosteroids CPT 83593 | not published | not published | $35.63 – $87.98 | 2 |
| Fracture assessment via dxa CPT 77086 | $124.80 | $156.00 | $283.48 – $283.48 | 1 |
| _fragile x methylation-sendout CPT 81244 | not published | not published | $56.11 – $138.58 | 2 |
| Fragmenting of kidney stone CPT 50590 | $1,099.20 | $1,374.00 | $10,458.39 – $10,458.39 | 1 |
| Freeing of bowel adhesion 44005 CPT 44005 | $1,615.20 | $2,019.00 | not published | 0 |
| Frenectomy 41115 CPT 41115 | $392.00 | $490.00 | $4,529.52 – $4,529.52 | 1 |
| Frenotomy 40806 CPT 40806 | $149.60 | $187.00 | $1,490.61 – $1,490.61 | 1 |
| Frenulotomy of penis CPT 54164 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Fresh frozen plasma 8-24 hours collection each unit HCPCS P9059 | $222.40 | $278.00 | $248.63 – $248.63 | 1 |
| Fresh frozen plasma frozen within 8 hours of collection each unit HCPCS P9017 | $199.20 | $249.00 | $278.87 – $278.87 | 1 |
| Fresh frozen plasma thawing ea un CPT 86927 | $92.80 | $116.00 | $513.12 – $513.12 | 1 |
| Frozen blood freeze/thaw CPT 86932 | not published | not published | $110.81 – $110.81 | 1 |
| Frozen blood prep CPT 86930 | not published | not published | $1,057.58 – $1,057.58 | 1 |
| Frozen blood thaw CPT 86931 | not published | not published | $1,057.58 – $1,057.58 | 1 |
| Frozen cell preparation CPT 88241 | not published | not published | $15.11 – $37.32 | 2 |
| Frozen plasma, pooled, sd HCPCS P9023 | not published | not published | $303.56 – $303.56 | 1 |
| Fructosamine glycated protein CPT 82985 | $83.20 | $104.00 | $20.95 – $51.74 | 2 |
| Ftl cgen abnor four anal CPT 81511 | not published | not published | $191.88 – $473.85 | 2 |
| Full field erg w/i&r CPT 92273 | not published | not published | $913.84 – $913.84 | 1 |
| Full mouth x-ray of teeth CPT 70320 | not published | not published | $761.98 – $761.98 | 1 |
| Full thick gft/nose/ear/lid/lip/20sqcm or< 15260 CPT 15260 | $1,500.00 | $1,875.00 | $5,631.53 – $5,631.53 | 1 |
| Full thick gft/scalp/arm/leg/20sqcm or< 15220 CPT 15220 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Full thick gft w/close donor fccmnaghf <=20sqcm 15240 CPT 15240 | $1,392.80 | $1,741.00 | $5,631.53 – $5,631.53 | 1 |
| Fundus photography with i&r 92250 CPT 92250 | $55.20 | $69.00 | $378.88 – $378.88 | 1 |
| Furosemide 10 mg/ml injection solution HCPCS J1938 | $78.90 | $98.62 | $0.05 – $0.06 | 2 |
| Fusion/graft of finger joint CPT 26862 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion/graft of hand joint CPT 26844 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of ankle joint open CPT 27870 | $1,487.20 | $1,859.00 | $42,576.18 – $42,576.18 | 1 |
| Fusion of big toe joint CPT 28750 | $1,154.40 | $1,443.00 | $21,583.67 – $21,583.67 | 1 |
| Fusion of big toe joint CPT 28755 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of finger joint CPT 26860 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of finger tendons CPT 26471 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of finger tendons CPT 26474 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Fusion of foot bones CPT 28730 | $1,074.40 | $1,343.00 | $42,576.18 – $42,576.18 | 1 |
| Fusion of foot bones CPT 28735 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Fusion of foot bones CPT 28740 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of hand joint CPT 26843 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of knuckle CPT 26850 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of knuckle joint CPT 26516 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of knuckle joints CPT 26517 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of knuckle joints CPT 26518 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of knuckle with graft CPT 26852 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Fusion of spermatic ducts CPT 54900 | not published | not published | $6,052.50 – $6,052.50 | 1 |
| Fusion of spermatic ducts CPT 54901 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Fusion of tendons at wrist CPT 25300 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of tendons at wrist CPT 25301 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Fusion of thumb CPT 26841 | $1,161.60 | $1,452.00 | $21,583.67 – $21,583.67 | 1 |
| Fusion of tibiofibular joint CPT 27871 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Fusion of toes CPT 28280 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| G0180 home health certification HCPCS G0180 | $80.00 | $100.00 | not published | 0 |
| G6pc gene CPT 81250 | not published | not published | $73.11 – $180.56 | 2 |
| G6pd full gene sequence CPT 81249 | not published | not published | $750.00 – $1,852.20 | 2 |
| G6pd gene alys cmn variant CPT 81247 | not published | not published | $218.51 – $539.64 | 2 |
| G6pd known familial variant CPT 81248 | not published | not published | $469.06 – $1,158.40 | 2 |
| Gadobutrol 1 mmol/ml intravenous solution (wrapper) HCPCS A9585 | not published | not published | $0.59 – $0.81 | 2 |
| Gadopentetate dimeglumine 469.01 mg/ml (46.9 %) intravenous (wrapper) HCPCS A9579 | not published | not published | $3.32 – $4.55 | 2 |
| Gadoterate meglumine 0.5 mmol/ml (376.9 mg/ml) intravenous solution HCPCS A9575 | not published | not published | $0.26 – $0.36 | 2 |
| Gadoxetate 0.25 mmol/ml (181.43 mg/ml) intravenous solution HCPCS A9581 | not published | not published | $33.08 – $45.39 | 2 |
| Galac-1-phosphate uridyltran - sendout CPT 82775 | not published | not published | $26.34 – $65.04 | 2 |
| Galactokinase - sendout CPT 82759 | not published | not published | $26.85 – $66.31 | 2 |
| Galactose transferase test CPT 82776 | not published | not published | $14.68 – $36.24 | 2 |
| Galectin-3 CPT 82777 | not published | not published | $55.31 – $136.60 | 2 |
| Gallbladder Removal (Laparoscopic) CPT 47562 | $980.80 | $1,226.00 | $17,007.37 – $17,007.37 | 1 |
| Gamma globulin > 10 cc inj HCPCS J1560 | not published | not published | $375.89 – $515.72 | 2 |
| Gamma globulin 1 cc inj HCPCS J1460 | not published | not published | $108.95 – $149.48 | 2 |
| Gammaglobulin iga CPT 82784 | $112.80 | $141.00 | $11.63 – $28.71 | 2 |
| Gammaglobulin ige CPT 82785 | $117.60 | $147.00 | $20.58 – $50.81 | 2 |
| Gamma glutamyltransferase CPT 82977 | $35.20 | $44.00 | $9.00 – $22.23 | 2 |
| Gammaplex injection HCPCS J1557 | not published | not published | $140.55 – $192.83 | 2 |
| Gamunex-c/gammaked HCPCS J1561 | not published | not published | $108.07 – $148.27 | 2 |
| Ganciclovir in ns IV syringe 10 mg/ml (neo/ped) - cnr HCPCS J1570 | not published | not published | $89.14 – $122.30 | 2 |
| Gardner vag dna quant CPT 87512 | not published | not published | $52.20 – $128.91 | 2 |
| Gastric analy w/ph ea spec CPT 82930 | not published | not published | $8.39 – $20.71 | 2 |
| Gastric emptying imag study CPT 78265 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Gastric emptying imag study CPT 78266 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Gastric motility studies CPT 91020 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Gastric mucosa imaging CPT 78261 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Gastrin test CPT 82938 | not published | not published | $22.11 – $54.61 | 2 |
| Gastroesophageal reflux study CPT 78262 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Gastroesophageal reflux test CPT 91034 | not published | not published | $1,577.43 – $1,577.43 | 1 |
| Gastrostomy open neonatal CPT 43831 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Gated heart multiple CPT 78473 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Gba gene CPT 81251 | not published | not published | $59.06 – $145.86 | 2 |
| Gel-one HCPCS J7326 | not published | not published | $1,179.04 – $1,617.64 | 2 |
| Gel-syn injection 0.1 mg HCPCS J7328 | not published | not published | $1.47 – $2.02 | 2 |
| Gemcitabine 1 gram intravenous solution HCPCS J9201 | $188.25 | $235.31 | $6.66 – $9.13 | 2 |
| Gemtuzumab ozogamicin 4.5 mg (1 mg/ml initial concentration) IV soln HCPCS J9203 | not published | not published | $532.39 – $730.43 | 2 |
| Genetic tstg severe inh cond CPT 81443 | not published | not published | $3,060.70 – $7,558.70 | 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.