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 |
|---|---|---|---|---|
| Hyperthermia ntrstl prb>5 CPT 77615 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Hypnotherapy CPT 90880 | not published | not published | $247.51 – $247.51 | 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 |
| Ifnl3 gene CPT 81283 | not published | not published | $91.71 – $226.49 | 2 |
| Ifosfamide 1 gram intravenous solution HCPCS J9208 | not published | not published | $52.87 – $72.54 | 2 |
| Igh@/bcl2 translocation alys CPT 81278 | not published | not published | $259.14 – $639.97 | 2 |
| Igh gene rearrang dir probe CPT 81262 | not published | not published | $85.69 – $211.61 | 2 |
| Igh gene rearrange amp meth CPT 81261 | not published | not published | $247.49 – $611.20 | 2 |
| Igh@ var region somatic mutation analy CPT 81263 | not published | not published | $368.15 – $909.18 | 2 |
| Igk rearrangeabn clonal pop CPT 81264 | not published | not published | $215.91 – $533.22 | 2 |
| Ihc/icc per specimen each additional single antibody stain CPT 88341 | $263.20 | $329.00 | not published | 0 |
| Ihc/icc per specimen each multiplex antibody stain CPT 88344 | $184.80 | $231.00 | $1,057.58 – $1,057.58 | 1 |
| Ihc/icc per specimen initial single antibody stain CPT 88342 | $216.00 | $270.00 | $513.12 – $513.12 | 1 |
| Ikbkap gene CPT 81260 | not published | not published | $49.14 – $121.35 | 2 |
| Ileostomy/jejunostomy non-tube 44310 CPT 44310 | $1,531.20 | $1,914.00 | not published | 0 |
| Iloprost non-comp unit dose HCPCS Q4074 | not published | not published | $357.56 – $490.57 | 2 |
| Imetelstat 188 mg intravenous solution HCPCS J0870 | not published | not published | $128.30 – $176.03 | 2 |
| Img rta detcj/mntr ds staff CPT 92227 | $26.40 | $33.00 | $110.81 – $110.81 | 1 |
| Img rta detc/mntr ds phy/qhp CPT 92228 | $44.80 | $56.00 | $110.81 – $110.81 | 1 |
| Img rta detc/mntr ds poc aly CPT 92229 | not published | not published | $187.55 – $187.55 | 1 |
| Immt breast prosthesis 19340 CPT 19340 | not published | not published | $19,392.63 – $19,392.63 | 1 |
| Immune complex assay CPT 86332 | $149.60 | $187.00 | $30.46 – $75.23 | 2 |
| Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution HCPCS J1569 | $5,809.22 | $7,261.53 | $107.54 – $147.55 | 2 |
| Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution HCPCS J1566 | not published | not published | $183.83 – $252.21 | 2 |
| Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution HCPCS J1568 | not published | not published | $108.85 – $149.34 | 2 |
| Immunoassay tumor antigen quantitative ca 125 CPT 86304 | $88.00 | $110.00 | $26.01 – $64.24 | 2 |
| Immunoassay tumor antigen quantitative ca 19-9 CPT 86301 | $124.00 | $155.00 | $26.01 – $64.24 | 2 |
| Immunoassay tumor qual CPT 86294 | not published | not published | $31.96 – $78.93 | 2 |
| Immunodiff gel qual ea antigen/ab CPT 86331 | $122.40 | $153.00 | $14.98 – $36.98 | 2 |
| Immunodiffusion nes CPT 86329 | not published | not published | $17.56 – $43.37 | 2 |
| Immunofixation electrophoresis serum CPT 86334 | $120.80 | $151.00 | $27.93 – $68.96 | 2 |
| Immunofluorescence per specimen each additional single antibody stain CPT 88350 | $627.20 | $784.00 | not published | 0 |
| Immunofluorescence per specimen initial single antibody stain CPT 88346 | $716.80 | $896.00 | $1,057.58 – $1,057.58 | 1 |
| Immunoglobulin assay CPT 86023 | not published | not published | $15.58 – $38.46 | 2 |
| Impact tooth remov part bony HCPCS D7230 | not published | not published | $5,620.33 – $5,620.33 | 1 |
| Impedence cardiogram CPT 93701 | not published | not published | $378.88 – $378.88 | 1 |
| Implant cochlear device CPT 69930 | not published | not published | $108,779.48 – $108,779.48 | 1 |
| Implant eye drug system CPT 67027 | not published | not published | $52,274.27 – $52,274.27 | 1 |
| Implant hormone pellet(s) 11980 CPT 11980 | $140.80 | $176.00 | $1,232.01 – $1,232.01 | 1 |
| Implant neuroelectrodes CPT 63655 | not published | not published | $70,205.09 – $70,205.09 | 1 |
| Implant neuroelectrodes CPT 64553 | not published | not published | $39,001.55 – $39,001.55 | 1 |
| Implant neuroelectrodes CPT 64555 | not published | not published | $21,548.51 – $21,548.51 | 1 |
| Implant neuroelectrodes CPT 64561 | $1,062.40 | $1,328.00 | $21,548.51 – $21,548.51 | 1 |
| Implant neurostim arrays CPT 61886 | not published | not published | $95,797.36 – $95,797.36 | 1 |
| Implant spinal canal cath CPT 62351 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Implant spine infusion pump CPT 62361 | not published | not published | $55,270.57 – $55,270.57 | 1 |
| Implant spine infusion pump CPT 62362 | not published | not published | $55,270.57 – $55,270.57 | 1 |
| Impl neurostim electr perc CPT 63650 | not published | not published | $21,548.51 – $21,548.51 | 1 |
| Implnt spinl canal catheter 62350 CPT 62350 | not published | not published | $20,161.06 – $20,161.06 | 1 |
| Impl oi implt sk tc esp<100 CPT 69716 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Impl oi implt sk tc esp>=100 CPT 69729 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Impl oi implt skull perq esp CPT 69714 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Impltj ntrstrml crnl rng seg CPT 65785 | not published | not published | $13,037.66 – $13,037.66 | 1 |
| Impres&prep auricular prosth CPT 21086 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep def obt prosth CPT 21080 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep facial prosth CPT 21088 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep intrm obt prosth CPT 21079 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep mndbl res prosth CPT 21081 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Impres&prep nasal prosth CPT 21087 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Impres&prep oral surg splint CPT 21085 | not published | not published | $678.14 – $678.14 | 1 |
| Impres&prep orbital prosth CPT 21077 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Impres&prep paltl aug prosth CPT 21082 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep paltl lft prosth CPT 21083 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Impres&prep sp aid prosth CPT 21084 | not published | not published | $9,283.38 – $9,283.38 | 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.