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 |
|---|---|---|---|---|
| Antithrombin iii injection HCPCS J7197 | not published | not published | $9.19 – $12.61 | 2 |
| Anti-thymocyte glob (equine)(1:1000) intradermal test dose HCPCS J7504 | not published | not published | $11,279.50 – $15,475.47 | 2 |
| Antithymocyte globuln rabbit HCPCS J7511 | not published | not published | $2,241.88 – $3,075.86 | 2 |
| Ant/post colporrhap/enterocele rpr 57265 CPT 57265 | $1,288.00 | $1,610.00 | $15,124.47 – $15,124.47 | 1 |
| Ant sgm img ir flrscn angrph CPT 92287 | not published | not published | $378.88 – $378.88 | 1 |
| Ant sgm img i&r speclr mic CPT 92286 | not published | not published | $378.88 – $378.88 | 1 |
| Aortic dysfunction/dilation CPT 81410 | not published | not published | $630.00 – $1,555.85 | 2 |
| Aortic dysfunction/dilation CPT 81411 | not published | not published | $1,687.74 – $4,168.04 | 2 |
| Apc gene dup/delet variants CPT 81203 | not published | not published | $250.00 – $617.40 | 2 |
| Apc gene full sequence CPT 81201 | not published | not published | $975.00 – $2,407.86 | 2 |
| Apc gene known fam variants CPT 81202 | not published | not published | $350.00 – $864.36 | 2 |
| Aphakia prosth service temp CPT 92358 | not published | not published | $187.55 – $187.55 | 1 |
| Apheresis immunoads slctv CPT 36516 | not published | not published | $13,574.19 – $13,574.19 | 1 |
| Apheresis plasma CPT 36514 | not published | not published | $4,437.20 – $4,437.20 | 1 |
| Apheresis platelets CPT 36513 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Apheresis rbc CPT 36512 | not published | not published | $4,437.20 – $4,437.20 | 1 |
| Apheresis wbc CPT 36511 | not published | not published | $4,437.20 – $4,437.20 | 1 |
| Apl(pml-rara) quant - sendout CPT 81315 | not published | not published | $259.14 – $639.97 | 2 |
| Appendectomy CPT 44950 | $952.00 | $1,190.00 | $11,557.38 – $11,557.38 | 1 |
| Appendectomy add-on 44955 CPT 44955 | $122.40 | $153.00 | not published | 0 |
| Appendectomy/open/rup/w/absc/peri 44960 CPT 44960 | $1,301.60 | $1,627.00 | not published | 0 |
| Appendix Removal (Laparoscopic) CPT 44970 | $893.60 | $1,117.00 | $17,007.37 – $17,007.37 | 1 |
| App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm CPT 15277 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| App high cost ss t/a/l >100sq cm 1st 100sq cm CPT 15273 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Appl bdy cst sho to hip 1thi CPT 29044 | not published | not published | $475.62 – $475.62 | 1 |
| Appl bdy cst sho to hip b th CPT 29046 | not published | not published | $782.84 – $782.84 | 1 |
| Appl bdy cst sho to hip head CPT 29040 | not published | not published | $782.84 – $782.84 | 1 |
| Appl body cast sho to hips CPT 29035 | not published | not published | $782.84 – $782.84 | 1 |
| Appl cast figure-of-eight CPT 29049 | $156.00 | $195.00 | $782.84 – $782.84 | 1 |
| Appl cast plaster velpeau CPT 29058 | not published | not published | $782.84 – $782.84 | 1 |
| Appl cast shoulder spica CPT 29055 | not published | not published | $782.84 – $782.84 | 1 |
| Appl halo type body cast CPT 29000 | not published | not published | $782.84 – $782.84 | 1 |
| Appl hip spica cast1&1/2 CPT 29325 | not published | not published | $782.84 – $782.84 | 1 |
| Appl hip spica cast 1 leg CPT 29305 | not published | not published | $782.84 – $782.84 | 1 |
| Application clubfoot cast CPT 29450 | $212.80 | $266.00 | $475.62 – $475.62 | 1 |
| Application finger splntstatic 29130 CPT 29130 | $60.80 | $76.00 | $378.88 – $378.88 | 1 |
| Application halo femoral CPT 20663 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Application halo pelvic CPT 20662 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Application long leg splint 29505 CPT 29505 | $127.20 | $159.00 | $475.62 – $475.62 | 1 |
| Application lower leg splint 29515 CPT 29515 | $103.20 | $129.00 | $475.62 – $475.62 | 1 |
| Application multi layer compression below knee (both sides) CPT 29581 | $221.60 | $277.00 | $475.62 – $475.62 | 1 |
| Application of body cast CPT 29010 | not published | not published | $782.84 – $782.84 | 1 |
| Application of body cast CPT 29015 | not published | not published | $782.84 – $782.84 | 1 |
| Application of cylinder cast 29365 CPT 29365 | $192.00 | $240.00 | $782.84 – $782.84 | 1 |
| Application of forearm cast 29075 CPT 29075 | $126.40 | $158.00 | $782.84 – $782.84 | 1 |
| Application of long arm cast 29065 CPT 29065 | $140.80 | $176.00 | $782.84 – $782.84 | 1 |
| Application of long leg cast CPT 29355 | $206.40 | $258.00 | $782.84 – $782.84 | 1 |
| Application of long leg cast 29345 CPT 29345 | $208.80 | $261.00 | $782.84 – $782.84 | 1 |
| Application of paste boot 29580 CPT 29580 | $94.40 | $118.00 | $475.62 – $475.62 | 1 |
| Application short leg cast 29405 CPT 29405 | $116.00 | $145.00 | $782.84 – $782.84 | 1 |
| Application skin substitute graft face/scalp/neck/genit/hnd/ft <100 sq cm 1st 25 sq cm CPT 15275 | $236.80 | $296.00 | $5,631.53 – $5,631.53 | 1 |
| Application skin substitute graft trunk/arms/legs <100 sq cm 1st 25 sq cm CPT 15271 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Appl long leg cast brace CPT 29358 | $251.20 | $314.00 | $782.84 – $782.84 | 1 |
| Appl mltpln uni ext fixj sys CPT 20692 | $1,708.80 | $2,136.00 | $42,576.18 – $42,576.18 | 1 |
| Appl modality 1/> areas paraffin bath 97018 CPT 97018 | $63.20 | $79.00 | not published | 0 |
| Appl multlay comprs arm/hand CPT 29584 | not published | not published | $475.62 – $475.62 | 1 |
| Appl patllr tdn bearing cast CPT 29435 | $192.00 | $240.00 | $782.84 – $782.84 | 1 |
| Appl unipln uni ext fixj sys CPT 20690 | $877.60 | $1,097.00 | $21,583.67 – $21,583.67 | 1 |
| Apply finger cast 29086 CPT 29086 | not published | not published | $475.62 – $475.62 | 1 |
| Apply forearm splintdynamic 29126 CPT 29126 | $121.60 | $152.00 | $378.88 – $378.88 | 1 |
| Apply hand/wrist cast 29085 CPT 29085 | $139.20 | $174.00 | $475.62 – $475.62 | 1 |
| Apply interstit radiat compl CPT 77778 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Apply intrcav radiat compl CPT 77763 | not published | not published | $2,354.99 – $2,354.99 | 1 |
| Apply intrcav radiat interm CPT 77762 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Apply intrcav radiat simple CPT 77761 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Apply of finger splint 29131 CPT 29131 | $84.00 | $105.00 | $187.55 – $187.55 | 1 |
| Apply rem fixation device CPT 20660 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Apply rigid leg cast 29445 CPT 29445 | $381.60 | $477.00 | $782.84 – $782.84 | 1 |
| Apply short leg castambul type 29425 CPT 29425 | $109.60 | $137.00 | $782.84 – $782.84 | 1 |
| Apply surf ldr radionuclide CPT 77789 | not published | not published | $399.35 – $399.35 | 1 |
| App mltpln uni xtrnl fix 1st CPT 20696 | not published | not published | $71,452.46 – $71,452.46 | 1 |
| App mltpln uni xtrnl fix xch CPT 20697 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Aprepitant 130 mg/18 ml (7.2 mg/ml) intravenous emulsion HCPCS J0185 | $679.90 | $849.87 | $3.99 – $5.47 | 2 |
| #aptt mix-1:1 incubated CPT 87532 | $520.00 | $650.00 | $43.86 – $108.32 | 2 |
| Aqaprn-4 antb flo cytmtry ea CPT 86053 | not published | not published | $47.16 – $116.47 | 2 |
| Aquaporin-4 antibody cba each CPT 86052 | not published | not published | $15.06 – $37.20 | 2 |
| Aquaporin-4 antibody elisa CPT 86051 | not published | not published | $14.41 – $35.59 | 2 |
| Aqua therapy w/exercise/ea 15 min 97113 CPT 97113 | $52.80 | $66.00 | not published | 0 |
| Aquatic exercise - group charge CPT 97150 | $52.80 | $66.00 | not published | 0 |
| Aqueous shunt eye w/graft CPT 66180 | not published | not published | $13,037.66 – $13,037.66 | 1 |
| Aqueous shunt eye without graft CPT 66179 | $1,590.40 | $1,988.00 | $13,037.66 – $13,037.66 | 1 |
| Argatroban nonesrd (auromed) HCPCS J0898 | not published | not published | $3.26 – $4.48 | 2 |
| Argatroban nonesrd use 1mg HCPCS J0883 | $570.63 | $713.29 | $1.66 – $2.28 | 2 |
| Aripiprazole 441 mg/1.6 ml inj HCPCS J1944 | not published | not published | $7.50 – $10.29 | 2 |
| Arsenic trioxide 2 mg/ml intravenous solution HCPCS J9017 | not published | not published | $13.18 – $18.08 | 2 |
| Arterial blood draw/perc 36620 CPT 36620 | $455.20 | $569.00 | not published | 0 |
| Artery to vein shunt CPT 36835 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery-vein nonautograft CPT 36830 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Artery xray of abdomen 75726-26 CPT 75726 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Artery x-rays adrenal gland CPT 75731 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays adrenals CPT 75733 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays arm/leg 75710-26 CPT 75710 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays arms/legs 75716-26 CPT 75716 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays chest CPT 75756 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays lung CPT 75741 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays lung CPT 75746 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery x-rays lungs CPT 75743 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Artery xrays of pelvis 75736 26 CPT 75736 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Artery x-rays spine CPT 75705 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Arthrd ant ntrbd min dsc crv CPT 22554 | not published | not published | $42,576.18 – $42,576.18 | 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.