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 |
|---|---|---|---|---|
| Hla i typing high res 1 allele grp ea CPT 81381 | not published | not published | $212.38 – $524.48 | 2 |
| Hla i typing low res one locus ea CPT 81373 | not published | not published | $159.29 – $393.38 | 2 |
| Hla typing a b or c CPT 86813 | not published | not published | $72.50 – $179.05 | 2 |
| Hla typing dr/dq CPT 86816 | not published | not published | $37.71 – $93.13 | 2 |
| Hla x-match noncytotoxc addl CPT 86826 | not published | not published | $45.66 – $112.77 | 2 |
| Hla x-math non-cytotoxic CPT 86825 | not published | not published | $136.86 – $338.00 | 2 |
| Hlth bhv assmt/reassessment CPT 96156 | not published | not published | $247.51 – $247.51 | 1 |
| Hlth bhv ivntj fam 1st 30 CPT 96167 | not published | not published | $96.85 – $96.85 | 1 |
| Hlth bhv ivntj grp 1st 30 CPT 96164 | not published | not published | $96.85 – $96.85 | 1 |
| Hlth bhv ivntj indiv 1st 30 CPT 96158 | not published | not published | $247.51 – $247.51 | 1 |
| Hocm 250-299mg/ml iodine,1ml HCPCS Q9961 | not published | not published | $0.64 – $0.88 | 2 |
| Hocm 350-399mg/ml iodine,1ml HCPCS Q9963 | not published | not published | $0.49 – $0.67 | 2 |
| Home health re-certification physician g0179 HCPCS G0179 | $63.20 | $79.00 | not published | 0 |
| Home sleep test/type 2 porta HCPCS G0398 | not published | not published | $474.53 – $474.53 | 1 |
| Home sleep test/type 3 porta HCPCS G0399 | not published | not published | $474.53 – $474.53 | 1 |
| Home sleep test/type 4 porta HCPCS G0400 | not published | not published | $913.84 – $913.84 | 1 |
| Home visit est patient 99348 CPT 99348 | $119.20 | $149.00 | not published | 0 |
| Homocysteine CPT 83090 | $104.00 | $130.00 | $22.40 – $55.32 | 2 |
| Homogenization tissue CPT 87176 | $68.00 | $85.00 | $7.35 – $18.15 | 2 |
| Homovanillic acid (hva) CPT 83150 | $80.80 | $101.00 | $28.01 – $69.18 | 2 |
| Hopd mntl hlt, 15-29 min HCPCS C7900 | not published | not published | $96.85 – $96.85 | 1 |
| Hopd mntl hlt, 30-60 min HCPCS C7901 | not published | not published | $247.51 – $247.51 | 1 |
| Hpa-15 genotyping CPT 81112 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-1 genotyping CPT 81105 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-2 genotyping CPT 81106 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-3 genotyping CPT 81107 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-4 genotyping CPT 81108 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-5 genotyping CPT 81109 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-6 genotyping CPT 81110 | not published | not published | $152.78 – $377.29 | 2 |
| Hpa-9 genotyping CPT 81111 | not published | not published | $152.78 – $377.29 | 2 |
| Hpv low-risk types CPT 87623 | not published | not published | $43.86 – $108.32 | 2 |
| Hpv types 16 & 18 only CPT 87625 | not published | not published | $50.69 – $125.18 | 2 |
| H pylori ag ia CPT 87339 | $51.20 | $64.00 | $20.00 – $49.39 | 2 |
| H pylori (c-13) blood CPT 83009 | not published | not published | $84.20 – $207.94 | 2 |
| H pylori (c-13) breath CPT 83013 | $280.80 | $351.00 | $84.20 – $207.94 | 2 |
| H pylori drug admin CPT 83014 | $32.80 | $41.00 | $9.83 – $24.26 | 2 |
| Hrdtry cardmypy gene panel CPT 81439 | not published | not published | $731.13 – $1,805.59 | 2 |
| Hrdtry perph neurphy panel CPT 81448 | not published | not published | $731.13 – $1,805.59 | 2 |
| Htt gene detc abnor alleles CPT 81271 | not published | not published | $171.25 – $422.92 | 2 |
| Human epididymis protein 4 (he4) CPT 86305 | $88.00 | $110.00 | $26.01 – $64.24 | 2 |
| Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution HCPCS J7165 | $2,155.26 | $2,694.08 | not published | 0 |
| Hyaluronidase 150 unit/ml injection solution HCPCS J3470 | not published | not published | $71.00 – $97.41 | 2 |
| Hyaluronidase 200 units/ml inj HCPCS J3471 | not published | not published | $1.12 – $1.54 | 2 |
| Hyaluronidase, human recombinant 150 unit/ml injection solution HCPCS J3473 | $207.69 | $259.61 | $0.82 – $1.12 | 2 |
| Hydralazine 20 mg/ml injection solution HCPCS J0360 | $77.99 | $97.49 | $11.67 – $16.02 | 2 |
| Hydration IV infusion each additional hour CPT 96361 | $115.20 | $144.00 | $138.26 – $138.26 | 1 |
| Hydration IV infusion initial 31minutes - 1 hour CPT 96360 | $416.00 | $520.00 | $674.04 – $674.04 | 1 |
| Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr HCPCS J1720 | $222.21 | $277.76 | $47.70 – $65.45 | 2 |
| Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper) HCPCS J1171 | $107.05 | $133.81 | $0.19 – $0.26 | 2 |
| Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge HCPCS J7999 | $70.80 | $88.50 | not published | 0 |
| Hydroxocobalamin im 10mcg HCPCS J3425 | not published | not published | $0.02 – $0.02 | 2 |
| Hydroxyzine hcl 50 mg/ml intramuscular solution HCPCS J3410 | $129.77 | $162.21 | $38.09 – $52.26 | 2 |
| Hydroxyzine pamoate 25 mg capsule HCPCS Q0177 | $4.88 | $6.10 | not published | 0 |
| Hydrxycorticsterds 17- (17-ohcs) CPT 83491 | $117.60 | $147.00 | $22.38 – $55.26 | 2 |
| Hymenotomy CPT 56442 | $68.80 | $86.00 | $9,225.99 – $9,225.99 | 1 |
| Hymovis injection 1 mg HCPCS J7322 | not published | not published | $39.24 – $53.84 | 2 |
| Hyoid myotomy & suspension CPT 21685 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| #hypersens-actinomyces ab CPT 86602 | $92.80 | $116.00 | $12.73 – $31.43 | 2 |
| Hyperthermia ext gen deep CPT 77605 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Hyperthermia ext gen supfc CPT 77600 | not published | not published | $857.96 – $857.96 | 1 |
| Hyperthermia gen intrcv prb CPT 77620 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Hyperthermia ntrstl prb 5/< CPT 77610 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Hyqvia 100mg immuneglobulin HCPCS J1575 | not published | not published | $41.37 – $56.76 | 2 |
| Hysterosalpingography s&i CPT 74740 | $398.40 | $498.00 | $761.98 – $761.98 | 1 |
| Hysteroscopy ablation CPT 58563 | $3,291.20 | $4,114.00 | $15,124.47 – $15,124.47 | 1 |
| Hysteroscopy biopsy CPT 58558 | $2,062.40 | $2,578.00 | $9,225.99 – $9,225.99 | 1 |
| Hysteroscopy dx sep proc CPT 58555 | $551.20 | $689.00 | $9,225.99 – $9,225.99 | 1 |
| Hysteroscopy lysis CPT 58559 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Hysteroscopy remove fb CPT 58562 | $654.40 | $818.00 | $9,225.99 – $9,225.99 | 1 |
| Hysteroscopy remove myoma CPT 58561 | $524.00 | $655.00 | $15,124.47 – $15,124.47 | 1 |
| Hysteroscopy resect septum CPT 58560 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Hysterotomy abdominal 59100 CPT 59100 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Hzv zoster vacc recombinant adjuvanted im inj CPT 90750 | $144.80 | $181.00 | not published | 0 |
| Iaadi respiratory synctial virus CPT 87280 | $48.00 | $60.00 | $16.78 – $41.43 | 2 |
| Iadna legionella pneumophila amplified probe tq CPT 87541 | $145.60 | $182.00 | $43.86 – $108.32 | 2 |
| Ia infect ag ab qual/semiquant sgl step CPT 86318 | $54.40 | $68.00 | $22.61 – $55.84 | 2 |
| Ia nfct ab sarscov2 covid19 CPT 86328 | not published | not published | $56.60 – $139.78 | 2 |
| Ibandronate 3 mg/3 ml intravenous syringe HCPCS J1740 | not published | not published | $69.30 – $95.09 | 2 |
| Ibmfs seq alys pnl 30 genes CPT 81441 | not published | not published | $3,060.70 – $7,558.70 | 2 |
| Ibuprofen injection HCPCS J1741 | not published | not published | $6.85 – $9.40 | 2 |
| Icg angiography i&r uni/bi CPT 92240 | not published | not published | $913.84 – $913.84 | 1 |
| Icut allergy test-delayed CPT 95028 | $18.40 | $23.00 | $110.81 – $110.81 | 1 |
| Icut allergy test drug/bug CPT 95024 | $12.00 | $15.00 | $187.55 – $187.55 | 1 |
| Icut allergy titrate-airborn CPT 95027 | not published | not published | $81.43 – $81.43 | 1 |
| I&d abscss rtrphryngl/paraphryngl intraorl apprch CPT 42720 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Idarubicin hcl injection HCPCS J9211 | not published | not published | $83.36 – $114.37 | 2 |
| I&d/bursa/foot 28001 CPT 28001 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Idecabtagene vicleucel car HCPCS Q2055 | not published | not published | $1,217,836.01 – $1,670,871.00 | 2 |
| Identify sperm tissue CPT 89264 | not published | not published | $163.59 – $163.59 | 1 |
| I&d frarm&/wrst deep absc/hematoma CPT 25028 | $1,049.60 | $1,312.00 | $9,712.92 – $9,712.92 | 1 |
| Idh1 common variants CPT 81120 | not published | not published | $241.56 – $596.56 | 2 |
| Idh2 common variants CPT 81121 | not published | not published | $369.74 – $913.10 | 2 |
| I&d intramural/intramuscular/submuc abscess transanal anes CPT 46045 | not published | not published | $8,384.23 – $8,384.23 | 1 |
| I&d lacrimal gland CPT 68400 | not published | not published | $2,847.45 – $2,847.45 | 1 |
| I&d lacrimal sac CPT 68420 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| I&d upper arm/elbow deep abscess/hematoma CPT 23930 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Idursulfase injection HCPCS J1743 | not published | not published | $1,256.76 – $1,724.27 | 2 |
| I & d vag hematoma non-ob 57023 CPT 57023 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| I&d vag hemtma obst/postpart CPT 57022 | $269.60 | $337.00 | $8,429.22 – $8,429.22 | 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.