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 |
|---|---|---|---|---|
| Inj efgart-alfa 2mg hya-qvfc HCPCS J9334 | not published | not published | $75.91 – $104.14 | 2 |
| Inj eflapegrastim-xnst 0.1mg HCPCS J1449 | not published | not published | $47.51 – $65.19 | 2 |
| Inj., emapalumab-lzsg, 1 mg HCPCS J9210 | not published | not published | $858.69 – $1,178.12 | 2 |
| Inj., emicizumab-kxwh 0.5 mg HCPCS J7170 | not published | not published | $129.23 – $177.30 | 2 |
| Inj epidural sgl cerv-thor without img CPT 62320 | $841.60 | $1,052.00 | $2,102.48 – $2,102.48 | 1 |
| Inj epidural sgl lumb-sacral without img CPT 62322 | $841.60 | $1,052.00 | $2,780.68 – $2,780.68 | 1 |
| Inj., eravacycline, 1 mg HCPCS J0122 | not published | not published | $2.90 – $3.98 | 2 |
| Inj, evinacumab-dgnb, 5mg HCPCS J1305 | not published | not published | $426.94 – $585.76 | 2 |
| Inj., evomela, 1 mg HCPCS J9246 | not published | not published | $39.09 – $53.63 | 2 |
| Inj, factor x, (human), 1iu HCPCS J7175 | not published | not published | $22.30 – $30.60 | 2 |
| Inj, faricimab-svoa, 0.1mg HCPCS J2777 | not published | not published | $77.58 – $106.43 | 2 |
| Inj. fe derisomaltose 10 mg HCPCS J1437 | not published | not published | $42.64 – $58.50 | 2 |
| Inj fensolvi 0.25 mg HCPCS J1951 | not published | not published | $315.96 – $433.50 | 2 |
| Inj., fibryga, 1 mg HCPCS J7177 | not published | not published | $2.72 – $3.73 | 2 |
| Inj fluphenazine hcl 1.25 mg HCPCS J2679 | not published | not published | $16.71 – $22.93 | 2 |
| Inj, focinvez, 1mg HCPCS J1434 | not published | not published | $6.46 – $8.86 | 2 |
| Inj, fosaprepitant (teva) HCPCS J1456 | not published | not published | $2.54 – $3.49 | 2 |
| Inj fosnetupitant, palonoset HCPCS J1454 | not published | not published | $1,364.30 – $1,871.81 | 2 |
| Inj, fulvestrant (fresenius) HCPCS J9394 | not published | not published | $7.47 – $10.26 | 2 |
| Inj, gadopiclenol, 1 ml HCPCS A9573 | not published | not published | $7.67 – $10.52 | 2 |
| Inj gemcitabine hcl (accord) HCPCS J9196 | not published | not published | $11.90 – $16.33 | 2 |
| Inj givosiran 0.5 mg HCPCS J0223 | not published | not published | $263.68 – $361.77 | 2 |
| Inj glofitamab gxbm, 2.5 mg HCPCS J9286 | not published | not published | $6,233.78 – $8,552.75 | 2 |
| Inj glycopyrrolate fres kabi HCPCS J1598 | not published | not published | $4.17 – $5.72 | 2 |
| Inj, granisetron, xr, 0.1 mg HCPCS J1627 | not published | not published | $11.16 – $15.31 | 2 |
| Inj., guselkumab, 1 mg HCPCS J1628 | not published | not published | $168.44 – $231.10 | 2 |
| Inj heparin, pfizer, 1000u HCPCS J1643 | not published | not published | $6.77 – $9.28 | 2 |
| Inj. herceptin hylecta, 10mg HCPCS J9356 | not published | not published | $141.69 – $194.40 | 2 |
| Inj, hercessi, 10 mg HCPCS Q5146 | not published | not published | $171.41 – $235.17 | 2 |
| Inj herzuma 10 mg HCPCS Q5113 | not published | not published | $174.36 – $239.22 | 2 |
| Inj human fibrinogen con nos HCPCS J7178 | not published | not published | $3.42 – $4.69 | 2 |
| Inj., ibalizumab-uiyk, 10 mg HCPCS J1746 | not published | not published | $178.62 – $245.06 | 2 |
| Inj imip 4 cilas 4 releb 2mg HCPCS J0742 | not published | not published | $5.87 – $8.06 | 2 |
| Inj, imm glob bivigam, 500mg HCPCS J1556 | not published | not published | $173.85 – $238.52 | 2 |
| Inj, immphentiv, 20 mcg HCPCS J2373 | not published | not published | $0.29 – $0.40 | 2 |
| Inj. inebilizumab-cdon, 1 mg HCPCS J1823 | not published | not published | $1,112.48 – $1,526.32 | 2 |
| Inj/inf neurolyt sbst spinal canal lesion 62282 CPT 62282 | not published | not published | $2,780.68 – $2,780.68 | 1 |
| Inj intralesional <= 7 lsn(s) CPT 11900 | $84.00 | $105.00 | $589.25 – $589.25 | 1 |
| Inj intralesional > 7 lsns CPT 11901 | $104.00 | $130.00 | $589.25 – $589.25 | 1 |
| Inj, invega hafyera/trinza HCPCS J2427 | not published | not published | $29.15 – $39.99 | 2 |
| Inj ivig privigen 500 mg HCPCS J1459 | $12,146.40 | $15,183.00 | $113.47 – $155.68 | 2 |
| Inj, ixinity, 1 i.u HCPCS J7213 | not published | not published | $4.30 – $5.91 | 2 |
| Inj. jivi 1 iu HCPCS J7208 | not published | not published | $5.96 – $8.18 | 2 |
| Inj, kovaltry, 1 i.u HCPCS J7211 | not published | not published | $3.56 – $4.88 | 2 |
| Inj labetalol hcl hikma, 5mg HCPCS J1921 | not published | not published | $3.11 – $4.27 | 2 |
| Inj., lanadelumab-flyo, 1 mg HCPCS J0593 | not published | not published | $195.62 – $268.38 | 2 |
| Inj, lanreotide, (cipla) 1mg HCPCS J1932 | not published | not published | $55.01 – $75.48 | 2 |
| Inj, lecanemab-irmb, 1 mg HCPCS J0174 | not published | not published | $2.99 – $4.10 | 2 |
| Inj, lenacapavir, 1 mg HCPCS J1961 | not published | not published | $49.55 – $67.99 | 2 |
| Inj levocarnitine per 1 gm HCPCS J1955 | $202.89 | $253.61 | $54.66 – $74.99 | 2 |
| Inj levoleucovorin nos 0.5mg HCPCS J0641 | not published | not published | $0.08 – $0.11 | 2 |
| Inj, levothyroxine, freskabi HCPCS J0651 | not published | not published | $15.96 – $21.90 | 2 |
| Inj, levothyroxine, hikma HCPCS J0652 | not published | not published | $11.56 – $15.85 | 2 |
| Inj, lidocaine w epinephrine HCPCS J2004 | $82.63 | $103.29 | not published | 0 |
| Inj, linezolid (hospira) HCPCS J2021 | not published | not published | $14.26 – $19.57 | 2 |
| Inj. lumasiran, 0.5 mg HCPCS J0224 | not published | not published | $740.48 – $1,015.94 | 2 |
| Inj marstacim-hncq, 0.5 mg HCPCS J7172 | not published | not published | $114.11 – $156.55 | 2 |
| Inj melpha hydroch nos 50 mg HCPCS J9245 | not published | not published | $243.07 – $333.49 | 2 |
| Inj melphalan (hepzato) 1 mg HCPCS J9248 | not published | not published | $1,772.52 – $2,431.90 | 2 |
| Inj mepivacaine hcl/10 ml HCPCS J0670 | not published | not published | $8.60 – $11.80 | 2 |
| Inj, meropenem (b. braun) HCPCS J2184 | not published | not published | $4.67 – $6.41 | 2 |
| Inj meropenem (wg crit care) HCPCS J2183 | not published | not published | $3.65 – $5.01 | 2 |
| Inj, micafungin (par pharm) HCPCS J2247 | not published | not published | $0.81 – $1.11 | 2 |
| Inj, mirikizumab-mrkz, 1 mg HCPCS J2267 | not published | not published | $108.61 – $149.02 | 2 |
| Inj mogamulizumab-kpkc, 1 mg HCPCS J9204 | not published | not published | $559.12 – $767.11 | 2 |
| Inj, motixafortide, 0.25 mg HCPCS J2277 | not published | not published | $56.74 – $77.85 | 2 |
| Inj, moxifloxacin 100 mg HCPCS J2280 | not published | not published | $19.60 – $26.89 | 2 |
| Inj moxifloxacin (fres kabi) HCPCS J2281 | not published | not published | $17.46 – $23.96 | 2 |
| Inj multihance HCPCS A9577 | not published | not published | $3.92 – $5.38 | 2 |
| Inj multihance multipack HCPCS A9578 | not published | not published | $3.85 – $5.28 | 2 |
| Inj. mycophenolate mofetil HCPCS J7519 | not published | not published | $0.93 – $1.28 | 2 |
| Inj. naxitamab-gqgk, 1 mg HCPCS J9348 | not published | not published | $1,543.29 – $2,117.39 | 2 |
| Inj nephrosto/ureterogram w/img exstng access CPT 50431 | not published | not published | $2,040.48 – $2,040.48 | 1 |
| Inj, nithiodote, 3mg / 125mg HCPCS J0211 | $45.56 | $56.95 | not published | 0 |
| Inj, nogapendekin pmln, 1mcg HCPCS J9028 | not published | not published | $211.76 – $290.53 | 2 |
| Inj non-compmd foam sclrsnt mlt trncl veins same leg CPT 36466 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Inj non-compmd foam sclrsnt sgl trncl vein CPT 36465 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Inj ocrelizumab 1mg hya-ocsq HCPCS J2351 | not published | not published | $106.29 – $145.84 | 2 |
| Inj octafluoropropane mic,ml HCPCS Q9956 | not published | not published | $92.70 – $127.18 | 2 |
| Inj ogivri 10 mg HCPCS Q5114 | $1,731.50 | $2,164.37 | $100.33 – $137.65 | 2 |
| Inj olipudase alfa-rpcp 1mg HCPCS J0218 | not published | not published | $886.10 – $1,215.73 | 2 |
| Inj., omadacycline, 1 mg HCPCS J0121 | not published | not published | $9.02 – $12.38 | 2 |
| Inj ontruzant 10 mg HCPCS Q5112 | not published | not published | $49.47 – $67.87 | 2 |
| Inj, palonosetron (posfrea) HCPCS J2468 | not published | not published | $132.38 – $181.62 | 2 |
| Inj pantoprazole(hikma) 40mg HCPCS J2471 | $74.16 | $92.70 | not published | 0 |
| Inj, panzyga, 500 mg HCPCS J1576 | not published | not published | $167.53 – $229.85 | 2 |
| Inj, pasireotide long acting HCPCS J2502 | not published | not published | $1,268.53 – $1,740.42 | 2 |
| Inj., patisiran, 0.1 mg HCPCS J0222 | not published | not published | $224.59 – $308.14 | 2 |
| Inj, pegcetacoplan, 1mg HCPCS J2781 | not published | not published | $319.30 – $438.08 | 2 |
| Inj pegfilgrastim-bmez 0.5mg HCPCS Q5120 | not published | not published | $62.97 – $86.40 | 2 |
| Inj. pemetrexed, 10 mg HCPCS J9304 | not published | not published | $118.67 – $162.81 | 2 |
| Inj pemetrexed (accord) 10mg HCPCS J9296 | not published | not published | $21.91 – $30.06 | 2 |
| Inj, pemetrexed (avyxa) 10mg HCPCS J9292 | not published | not published | $187.39 – $257.10 | 2 |
| Inj pemetrexed ditromethamin HCPCS J9323 | not published | not published | $23.27 – $31.93 | 2 |
| Inj pemetrexed, hospira 10mg HCPCS J9294 | not published | not published | $11.08 – $15.20 | 2 |
| Inj pemetrexed (sandoz) 10mg HCPCS J9297 | not published | not published | $2.72 – $3.73 | 2 |
| Inj pemetrexed (teva) 10mg HCPCS J9314 | not published | not published | $8.53 – $11.70 | 2 |
| Inj, pemivibart, 4500 mg HCPCS Q0224 | not published | not published | $16,287.75 – $22,346.79 | 2 |
| Inj, pemrydi rtu, 10 mg HCPCS J9324 | not published | not published | $180.23 – $247.27 | 2 |
| Inj., perseris, 0.5 mg HCPCS J2798 | not published | not published | $27.31 – $37.47 | 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.