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 |
|---|---|---|---|---|
| Genioplasty augmentation CPT 21120 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Geniop sldg augmentation CPT 21123 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Geniop sldg osteot 1 CPT 21121 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Geniop sldg osteot 2/> CPT 21122 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Genome sequence analysis CPT 81425 | not published | not published | $6,289.00 – $15,531.31 | 2 |
| Gentamicin 10 mg/ml liquid compound - enteral use only HCPCS J1580 | $153.23 | $191.54 | $5.88 – $8.07 | 2 |
| Gentamicin peak therapeutic drug level CPT 80170 | $256.00 | $320.00 | $20.48 – $50.57 | 2 |
| Genvisc 850, inj, 1mg HCPCS J7320 | not published | not published | $13.55 – $18.59 | 2 |
| G-esoph reflx tst w/electrod CPT 91035 | $650.40 | $813.00 | $1,577.43 – $1,577.43 | 1 |
| Ghs abscess perianal iandd CPT 46050 | $817.60 | $1,022.00 | $2,711.70 – $2,711.70 | 1 |
| Ghs abscess postoperative iandd complex CPT 10180 | $391.20 | $489.00 | $8,429.22 – $8,429.22 | 1 |
| Ghs acetylcholinesterase, rbc CPT 82482 | not published | not published | $12.26 – $30.28 | 2 |
| Ghs alcohol, methyl (methanol)-medtox CPT 84600 | $120.80 | $151.00 | $21.39 – $52.82 | 2 |
| Ghs alpha thalasemia, 7 deletions CPT 81257 | not published | not published | $127.83 – $315.68 | 2 |
| Ghs analysis neurostim without reprogramming CPT 95970 | not published | not published | $378.88 – $378.88 | 1 |
| Ghs antibodies (torch) igm CPT 86694 | $47.20 | $59.00 | $17.99 – $44.42 | 2 |
| Ghs aspiration bladder - needle CPT 51100 | not published | not published | $701.12 – $701.12 | 1 |
| Ghs bladder cath - complex-foley CPT 51703 | $223.20 | $279.00 | $474.53 – $474.53 | 1 |
| Ghs bleeding time (ivy) CPT 85002 | $59.20 | $74.00 | $6.03 – $14.88 | 2 |
| Ghs block ilioinguinal/gentitofemoral CPT 64425 | $165.60 | $207.00 | $2,102.48 – $2,102.48 | 1 |
| Ghs central line insert < age 5, failed CPT 36555 | $273.60 | $342.00 | $9,720.46 – $9,720.46 | 1 |
| Ghs change cysto/gastrost CPT 43762 | $348.00 | $435.00 | $701.12 – $701.12 | 1 |
| Ghs chemo >8 hrs CPT 96416 | $216.00 | $270.00 | $1,085.34 – $1,085.34 | 1 |
| Ghs chemo infusion >8 hrs CPT 96425 | not published | not published | $1,085.34 – $1,085.34 | 1 |
| Ghs chemo IV push, ea addtl CPT 96411 | $95.20 | $119.00 | $220.15 – $220.15 | 1 |
| Ghs chlamydia pneumoniae by pcr (arup) (306630) CPT 87486 | $71.20 | $89.00 | $43.86 – $108.32 | 2 |
| Ghs closd tx interphalang jt disloc w/ma CPT 26770 | $427.20 | $534.00 | $675.49 – $675.49 | 1 |
| Ghs closed reduction ankle dislocation CPT 27840 | $568.80 | $711.00 | $675.49 – $675.49 | 1 |
| Ghs closed tx bimalleolar fracture w/manip CPT 27810 | $2,022.40 | $2,528.00 | $4,680.86 – $4,680.86 | 1 |
| Ghs closed tx radiocarpal disloc w manip CPT 25660 | not published | not published | $675.49 – $675.49 | 1 |
| Ghs closed tx tibial fracture w/manip CPT 27752 | $1,092.80 | $1,366.00 | $4,680.86 – $4,680.86 | 1 |
| Ghs closure surg wound/dehiscence-13160 CPT 13160 | $1,168.80 | $1,461.00 | $5,631.53 – $5,631.53 | 1 |
| Ghs clsd red med malleolus fx without manip CPT 27760 | $524.00 | $655.00 | $675.49 – $675.49 | 1 |
| Ghs clsd red med malleolus fx w manip CPT 27762 | $1,092.80 | $1,366.00 | $4,680.86 – $4,680.86 | 1 |
| Ghs clsd tx frac distal tibia w/manipulation CPT 27825 | $807.20 | $1,009.00 | $4,680.86 – $4,680.86 | 1 |
| Ghs cl tx knee disl; wo anesth CPT 27550 | not published | not published | $675.49 – $675.49 | 1 |
| Ghs cl tx metacarpophal disloc without anes CPT 26700 | $505.60 | $632.00 | $675.49 – $675.49 | 1 |
| Ghs community re-entry 15 minutes CPT 97537 | $84.80 | $106.00 | not published | 0 |
| Ghs conjunctiva foreign body-embed bil CPT 65210 | $56.80 | $71.00 | $1,232.01 – $1,232.01 | 1 |
| Ghs conjunctiva foreign body-superf bil CPT 65205 | $52.00 | $65.00 | $378.88 – $378.88 | 1 |
| Ghs corneal fb without slit lamp bilat CPT 65220 | $750.40 | $938.00 | $1,232.01 – $1,232.01 | 1 |
| Ghs corneal fb with slit lamp bilat CPT 65222 | $778.40 | $973.00 | $378.88 – $378.88 | 1 |
| Ghs cricothyroidotomy CPT 31605 | not published | not published | $678.14 – $678.14 | 1 |
| Ghs cutdown placement age 1 and over CPT 36425 | not published | not published | $1,232.01 – $1,232.01 | 1 |
| Ghs cutdown placement under 1 yr CPT 36420 | not published | not published | $378.88 – $378.88 | 1 |
| Ghs diphtheria toxoid ab igg CPT 86648 | not published | not published | $19.01 – $46.95 | 2 |
| Ghs dislocation elbow closed treatment CPT 24600 | $559.20 | $699.00 | $675.49 – $675.49 | 1 |
| Ghs ed peritoneal lavage w guidance if performed CPT 49084 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Ghs ed rmvl or bivalving cast CPT 29700 | $100.00 | $125.00 | $782.84 – $782.84 | 1 |
| Ghs ed therapeutic lp, drain csf w fluoro CPT 62329 | $1,038.40 | $1,298.00 | $2,102.48 – $2,102.48 | 1 |
| Ghs eeg cont rec w/video by tec min 8 chnls CPT 95700 | not published | not published | $474.53 – $474.53 | 1 |
| Ghs electrostagmgraphy CPT 92537 | not published | not published | $474.53 – $474.53 | 1 |
| Ghs elect torsion swing CPT 92546 | not published | not published | $474.53 – $474.53 | 1 |
| Ghs epidermal shaving diameter >2.0 cm CPT 11303 | $226.40 | $283.00 | $1,217.32 – $1,217.32 | 1 |
| Ghs excision ingrown nail CPT 11765 | $245.60 | $307.00 | $1,217.32 – $1,217.32 | 1 |
| Ghs eye exam CPT 92002 | not published | not published | $394.38 – $394.38 | 1 |
| Ghs eyelid foreign body-embedded - bil CPT 67938 | not published | not published | $863.77 – $863.77 | 1 |
| Ghs fat & muscle CPT 89160 | not published | not published | $6.06 – $14.97 | 2 |
| Ghs fb removal foot - deep - left CPT 28192 | $675.20 | $844.00 | $4,893.07 – $4,893.07 | 1 |
| Ghs fb removal from muscle - complicated CPT 20525 | $695.20 | $869.00 | $8,429.22 – $8,429.22 | 1 |
| Ghs fb removal - incisional CPT 10121 | $392.00 | $490.00 | $4,893.07 – $4,893.07 | 1 |
| Ghs fb removal - non-incisional CPT 20520 | $322.40 | $403.00 | $4,893.07 – $4,893.07 | 1 |
| Ghs febrile agglutinns(mayo) CPT 86000 | $30.40 | $38.00 | $8.73 – $21.55 | 2 |
| Ghs fish cytogen CPT 88271 | $390.40 | $488.00 | $26.78 – $66.12 | 2 |
| Ghs fish hybrid in situ 100-300 CPT 88275 | $390.40 | $488.00 | $63.99 – $158.02 | 2 |
| Ghs flow volume loop CPT 94375 | $302.40 | $378.00 | $913.84 – $913.84 | 1 |
| Ghs gastric intub aspiration lavage CPT 43753 | $200.00 | $250.00 | $913.84 – $913.84 | 1 |
| Ghs hcv amplificaiton CPT 87521 | $201.60 | $252.00 | $43.86 – $108.32 | 2 |
| Ghs heavy metals bld (ars,lead,merc) CPT 82715 | not published | not published | $28.71 – $70.91 | 2 |
| Ghs hepatitis c virus (hcv riba) CPT 86804 | $208.00 | $260.00 | $19.36 – $47.82 | 2 |
| Ghs hgb stability-thal CPT 83068 | not published | not published | $11.84 – $29.23 | 2 |
| Ghs histoplasma antigen CPT 87385 | $377.60 | $472.00 | $16.56 – $40.90 | 2 |
| Ghs HIV antibody CPT 86703 | $91.20 | $114.00 | $17.14 – $42.32 | 2 |
| Ghs hla-dr/dq, multiple antigens CPT 86817 | not published | not published | $132.68 – $327.65 | 2 |
| Ghs i and d abscess/hematoma scrotum CPT 54700 | $2,978.40 | $3,723.00 | $6,052.50 – $6,052.50 | 1 |
| Ghs i and d perirectal abscess 46040 CPT 46040 | $1,458.40 | $1,823.00 | $3,533.55 – $3,533.55 | 1 |
| Ghs i and d pilonidal cyst complex CPT 10081 | $504.00 | $630.00 | $2,117.62 – $2,117.62 | 1 |
| Ghs i and d pilonidal cyst simple CPT 10080 | $383.20 | $479.00 | $2,117.62 – $2,117.62 | 1 |
| Ghs immun0electrophoresis CPT 86320 | not published | not published | $37.40 – $92.36 | 2 |
| Ghs incision thrombosed ext hemorrhoid CPT 46083 | $316.00 | $395.00 | $701.12 – $701.12 | 1 |
| Ghs indirect laryngoscopy/w fb removal CPT 31511 | not published | not published | $583.27 – $583.27 | 1 |
| Ghs inhibitor screen CPT 85335 | $198.40 | $248.00 | $16.09 – $39.73 | 2 |
| Ghs init tx 1st degree burn CPT 16000 | $112.00 | $140.00 | $589.25 – $589.25 | 1 |
| Ghs inj neurolytic intercostal nerve CPT 64620 | not published | not published | $2,780.68 – $2,780.68 | 1 |
| Ghs inj neurolytic other perph nerve CPT 64640 | $369.60 | $462.00 | $2,780.68 – $2,780.68 | 1 |
| Ghs inj tendon origin/insertion CPT 20551 | $86.40 | $108.00 | $887.20 – $887.20 | 1 |
| Ghs inj transforaminal cerv single bil CPT 64479 | not published | not published | $2,780.68 – $2,780.68 | 1 |
| Ghs insertion of needle - bone CPT 36680 | $437.60 | $547.00 | $1,232.01 – $1,232.01 | 1 |
| Ghs intermed repair 12.6 - 20.0 cm-12035 CPT 12035 | $578.40 | $723.00 | $1,217.32 – $1,217.32 | 1 |
| Ghs intermed repair 20.1 - 30.0 cm-12036 CPT 12036 | $644.80 | $806.00 | $1,895.66 – $1,895.66 | 1 |
| Ghs intermed repair over 30 cm - 12037 CPT 12037 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Ghs irrigate corpora cavernosa for priapism CPT 54220 | not published | not published | $701.12 – $701.12 | 1 |
| Ghs IV inf sq injection, on-body injector CPT 96377 | not published | not published | $138.26 – $138.26 | 1 |
| Ghs IV infusion bamlanivimab/etesevimab HCPCS M0245 | not published | not published | $1,469.99 – $1,469.99 | 1 |
| Ghs IV infusion casirivimab/imdevimab HCPCS M0243 | not published | not published | $1,469.99 – $1,469.99 | 1 |
| Ghs IV infusion sotrovimab HCPCS M0247 | not published | not published | $1,469.99 – $1,469.99 | 1 |
| Ghs IV thrombolytics - cerebral CPT 37195 | $574.40 | $718.00 | $1,085.34 – $1,085.34 | 1 |
| Ghs lac repair mouth.ant tong 2.5cm/less CPT 41250 | $423.20 | $529.00 | $1,232.01 – $1,232.01 | 1 |
| Ghs layer closure 2.5 cm or less - 12031 CPT 12031 | $392.80 | $491.00 | $1,217.32 – $1,217.32 | 1 |
| Ghs layer closure 2.5 cm or less - 12041 CPT 12041 | $524.80 | $656.00 | $1,217.32 – $1,217.32 | 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.