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 |
|---|---|---|---|---|
| Hc nm kidney imaging with flow CPT 78701 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Hc nm myocard infarct avid plnr tomo spect w/wo quant CPT 78469 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Hc pet myocardial imaging metabolic eval single study CPT 78459 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77770 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77771 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Hdr rdncl ntrstl/icav brchtx CPT 77772 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Hdr rdncl skn surf brachytx CPT 77767 | not published | not published | $857.96 – $857.96 | 1 |
| Hdr rdncl skn surf brachytx CPT 77768 | not published | not published | $857.96 – $857.96 | 1 |
| Head CT scan (with and without contrast) CPT 70470 | $1,296.00 | $1,620.00 | $588.44 – $588.44 | 1 |
| Head CT scan (with contrast) CPT 70460 | $1,057.60 | $1,322.00 | $588.44 – $588.44 | 1 |
| Head CT scan (without contrast) CPT 70450 | $829.60 | $1,037.00 | $348.75 – $348.75 | 1 |
| Hearing loss dup/del analys CPT 81431 | not published | not published | $849.46 – $2,097.83 | 2 |
| Hearing loss sequence analys CPT 81430 | not published | not published | $2,031.25 – $5,016.38 | 2 |
| Heart first pass multiple CPT 78483 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Heart image spect CPT 78494 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Heart infarct image CPT 78466 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Heart infarct image (ef) CPT 78468 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Heavy metal qual any number CPT 83015 | $224.80 | $281.00 | $26.18 – $64.64 | 2 |
| Heinz bodies direct CPT 85441 | not published | not published | $5.25 – $12.97 | 2 |
| Heinz bodies induced CPT 85445 | not published | not published | $8.53 – $21.05 | 2 |
| Helicobacter pylori antibody igm CPT 86677 | $149.60 | $187.00 | $21.06 – $52.02 | 2 |
| Helicoll, per square cm HCPCS Q4164 | not published | not published | $3,692.09 – $5,065.55 | 2 |
| Hemagglutination inhibition CPT 86280 | not published | not published | $10.24 – $25.28 | 2 |
| Hematocrit CPT 85014 | $41.60 | $52.00 | $2.96 – $7.32 | 2 |
| Hematopoietic nuclear tx CPT 79403 | not published | not published | $814.87 – $814.87 | 1 |
| Hemiepiphyseal arrest CPT 24470 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Hemin 350 mg intravenous powder for solution HCPCS J1640 | not published | not published | $76.87 – $105.47 | 2 |
| Hemodialysis one evaluation CPT 90935 | not published | not published | $2,057.41 – $2,057.41 | 1 |
| Hemoglobin CPT 85018 | $29.60 | $37.00 | $2.96 – $7.32 | 2 |
| Hemoglobin copper sulfate CPT 83026 | not published | not published | $5.01 – $12.38 | 2 |
| Hemoglobin fetal qualitative CPT 83033 | $24.00 | $30.00 | $10.00 – $24.70 | 2 |
| Hemoglobin f (fetal) chemical CPT 83030 | not published | not published | $13.43 – $33.15 | 2 |
| Hemoglobin methemoglobin quantitative CPT 83050 | not published | not published | $10.25 – $25.31 | 2 |
| Hemoglobin-oxygen affinity CPT 82820 | not published | not published | $16.68 – $41.18 | 2 |
| Hemoglobin plasma CPT 83051 | $132.80 | $166.00 | $9.14 – $22.57 | 2 |
| Hemoglobin thermolabile CPT 83065 | not published | not published | $11.25 – $27.78 | 2 |
| Hemoglobin urine CPT 83069 | not published | not published | $4.94 – $12.19 | 2 |
| Hemolysin acid CPT 85475 | not published | not published | $11.09 – $27.38 | 2 |
| Hemolysins/agglutinins auto CPT 86940 | not published | not published | $10.96 – $27.07 | 2 |
| Hemolysins and agglutinins incubated CPT 86941 | not published | not published | $15.14 – $37.38 | 2 |
| Hemophilus influenza antibdy CPT 86684 | not published | not published | $19.80 – $48.90 | 2 |
| Hemorrhoidectomy intern transanal deater 2+ 46948 CPT 46948 | $663.20 | $829.00 | $8,384.23 – $8,384.23 | 1 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $428.00 | $535.00 | $2,711.70 – $2,711.70 | 1 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | $576.00 | $720.00 | $8,384.23 – $8,384.23 | 1 |
| Hepagam b im injection HCPCS J1571 | not published | not published | $161.24 – $221.22 | 2 |
| Hepagam b intravenous, inj HCPCS J1573 | $386.40 | $483.00 | $161.24 – $221.22 | 2 |
| Heparin assay CPT 85520 | $172.00 | $215.00 | $16.36 – $40.41 | 2 |
| Heparin bolus from bag HCPCS J1644 | $81.12 | $101.40 | $0.49 – $0.67 | 2 |
| Heparin neutralization CPT 85525 | $135.20 | $169.00 | $14.80 – $36.55 | 2 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $65.16 | $81.45 | $0.04 – $0.06 | 2 |
| Heparin-protamine tolerance CPT 85530 | not published | not published | $16.36 – $40.41 | 2 |
| Hepatitis a antibody igm CPT 86709 | $112.80 | $141.00 | $14.08 – $34.76 | 2 |
| Hepatitis b core antibody igm CPT 86705 | $102.40 | $128.00 | $14.71 – $36.33 | 2 |
| Hepatitis b core antibody total CPT 86704 | $94.40 | $118.00 | $15.06 – $37.20 | 2 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | not published | not published | $293.99 – $403.36 | 2 |
| Hepatitis b surface ag quan CPT 87467 | not published | not published | $31.65 – $78.16 | 2 |
| Hepatitis b surface antibody CPT 86706 | $102.40 | $128.00 | $13.43 – $33.15 | 2 |
| Hepatitis b vaccine 40 mcg/ml inj-adult CPT 90747 | not published | not published | $316.69 – $434.50 | 2 |
| Hepatitis c antibody CPT 86803 | $131.20 | $164.00 | $17.84 – $44.05 | 2 |
| Hepatitis c rna dir probe CPT 87520 | not published | not published | $39.03 – $96.38 | 2 |
| Hepatitis d quantification CPT 87523 | not published | not published | $53.55 – $132.25 | 2 |
| Hepatitis g dna amp probe CPT 87526 | not published | not published | $49.08 – $121.20 | 2 |
| Hepatitis g dna dir probe CPT 87525 | not published | not published | $37.25 – $91.99 | 2 |
| Hepatitis g dna quant CPT 87527 | not published | not published | $52.20 – $128.91 | 2 |
| Hepatobiliary system imaging CPT 78226 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Hep b vac 3ag 10mcg 3 dos im CPT 90759 | not published | not published | $166.08 – $227.87 | 2 |
| Hepb vacc 3 dose immunsup im CPT 90740 | not published | not published | $369.95 – $507.57 | 2 |
| Hereditary colon ca dsordrs CPT 81435 | not published | not published | $1,629.94 – $4,025.29 | 2 |
| Hered neuroend tum-rlt do 5+ CPT 81437 | $3,549.60 | $4,437.00 | $1,629.94 – $4,025.29 | 2 |
| Hered rta do gen seq 15 CPT 81434 | $5,321.60 | $6,652.00 | $747.39 – $1,845.75 | 2 |
| Hernia Repair (Inguinal) CPT 49505 | $776.80 | $971.00 | $11,557.38 – $11,557.38 | 1 |
| Herpes simplex 1 ag if CPT 87274 | not published | not published | $14.98 – $36.98 | 2 |
| Herpes simplex 2 ag if CPT 87273 | not published | not published | $14.98 – $36.98 | 2 |
| Herpes simplex type 1 antibody igg CPT 86695 | $390.40 | $488.00 | $16.49 – $40.72 | 2 |
| Herpes simplex type 2 antibody igg CPT 86696 | $68.80 | $86.00 | $24.19 – $59.73 | 2 |
| Herpes simplex virus isolation CPT 87255 | $77.60 | $97.00 | $42.33 – $104.53 | 2 |
| Heterophile antibodies screening CPT 86308 | $96.00 | $120.00 | $6.48 – $15.99 | 2 |
| Heterophile antibodies titer CPT 86309 | not published | not published | $8.09 – $19.97 | 2 |
| Heterophile antibody absrbj CPT 86310 | not published | not published | $9.21 – $22.75 | 2 |
| Hexa gene CPT 81255 | not published | not published | $64.31 – $158.83 | 2 |
| Hgb methemoglobin qual CPT 83045 | not published | not published | $8.11 – $20.03 | 2 |
| Hhv-6 dna dir probe CPT 87531 | not published | not published | $72.50 – $179.05 | 2 |
| Hhv-6 dna quant CPT 87533 | not published | not published | $52.20 – $128.91 | 2 |
| Hi enrgy eswt plantar fascia CPT 28890 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| High inten beh couns std 30m HCPCS G0445 | $48.80 | $61.00 | $247.51 – $247.51 | 1 |
| Hip arthr0 w/debridement CPT 29862 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip arthr0 w/synovectomy CPT 29863 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Hip arthro acetabuloplasty CPT 29915 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip arthroscopy dx CPT 29860 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip arthro w/fb removal CPT 29861 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip arthro w/femoroplasty CPT 29914 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip arthro w/labral repair CPT 29916 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Hip X-ray CPT 73502 | $178.40 | $223.00 | $283.48 – $283.48 | 1 |
| Histamine CPT 83088 | $73.60 | $92.00 | $36.91 – $91.16 | 2 |
| Histochemical stains add-on CPT 88314 | $212.80 | $266.00 | not published | 0 |
| Histoplasmosis skin test CPT 86510 | $88.00 | $110.00 | $187.55 – $187.55 | 1 |
| Hiv-1 ag ia CPT 87390 | $73.60 | $92.00 | $30.08 – $74.27 | 2 |
| Hiv-1 dna dir probe CPT 87534 | not published | not published | $27.40 – $67.67 | 2 |
| Hiv-2 ag ia CPT 87391 | not published | not published | $27.38 – $67.61 | 2 |
| HIV 2 pcr qual - sendout CPT 87537 | not published | not published | $27.40 – $67.67 | 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.