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 |
|---|---|---|---|---|
| Ntrk3 translocation analysis CPT 81193 | not published | not published | $259.14 – $639.97 | 2 |
| Ntrk translocation analysis CPT 81194 | not published | not published | $647.85 – $1,599.93 | 2 |
| Ntrprof ph1/ntrnet/ehr 11-20 CPT 99447 | $53.60 | $67.00 | not published | 0 |
| Ntrprof ph1/ntrnet/ehr 21-30 CPT 99448 | $79.20 | $99.00 | not published | 0 |
| Ntrprof ph1/ntrnet/ehr 31/> CPT 99449 | $107.20 | $134.00 | not published | 0 |
| Ntrprof ph1/ntrnet/ehr 5/> CPT 99451 | $51.20 | $64.00 | not published | 0 |
| Ntrprof ph1/ntrnet/ehr 5-10 CPT 99446 | $26.40 | $33.00 | not published | 0 |
| Ntrprof ph1/ntrnet/ehr rfrl CPT 99452 | $52.00 | $65.00 | not published | 0 |
| Ntsty modul rad tx dlvr cplx CPT 77386 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Ntsty modul rad tx dlvr smpl CPT 77385 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Nuclear exam of tear flow CPT 78660 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Nuclear matrix protein 22 CPT 86386 | not published | not published | $27.23 – $67.23 | 2 |
| Nuclear rx intra-arterial CPT 79445 | not published | not published | $814.87 – $814.87 | 1 |
| Nuclear rx intra-articular CPT 79440 | not published | not published | $814.87 – $814.87 | 1 |
| Nuclear rx intracav admin CPT 79200 | not published | not published | $814.87 – $814.87 | 1 |
| Nuclear rx IV admin CPT 79101 | not published | not published | $814.87 – $814.87 | 1 |
| Nuclear Stress Test (Heart) CPT 78452 | $627.20 | $784.00 | $4,330.91 – $4,330.91 | 1 |
| Nuclr rx interstit colloid CPT 79300 | not published | not published | $814.87 – $814.87 | 1 |
| Nudt15 gene common variants CPT 81306 | not published | not published | $364.20 – $899.43 | 2 |
| Nursing fac care supervision CPT 99379 | $101.60 | $127.00 | not published | 0 |
| Nursing fac care supervision CPT 99380 | $152.80 | $191.00 | not published | 0 |
| Nursing facility discharge management > 30 min 99316 CPT 99316 | $148.80 | $186.00 | not published | 0 |
| Nursing facility discharge management 30 min/less than 99315 CPT 99315 | $104.00 | $130.00 | not published | 0 |
| Nushield 1 square cm HCPCS Q4160 | not published | not published | $1,192.50 – $1,636.11 | 2 |
| Obinutuzumab 1,000 mg/40 ml intravenous solution HCPCS J9301 | $11,311.98 | $14,139.97 | $176.54 – $242.21 | 2 |
| Observation direct referral from physician office for admission HCPCS G0379 | $450.40 | $563.00 | $1,788.50 – $1,788.50 | 1 |
| Observation/inpatient hospital care hi severity 99236 CPT 99236 | $304.00 | $380.00 | not published | 0 |
| Observation/inpatient hospital care low severity 99234 CPT 99234 | $187.20 | $234.00 | not published | 0 |
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $237.60 | $297.00 | not published | 0 |
| Observation per hour HCPCS G0378 | $46.40 | $58.00 | not published | 0 |
| Obstetrical care 59410 CPT 59410 | $1,460.80 | $1,826.00 | not published | 0 |
| Obstetric panel inc HIV tstg CPT 80081 | not published | not published | $93.58 – $231.09 | 2 |
| Obstetrics panel CPT 80055 | $325.60 | $407.00 | $59.76 – $147.59 | 2 |
| Obtaining screen pap smear HCPCS Q0091 | $63.20 | $79.00 | $81.43 – $81.43 | 1 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $261.60 | $327.00 | $348.75 – $348.75 | 1 |
| Occlude fallopian tube(s) device 58615 CPT 58615 | not published | not published | $9,225.99 – $9,225.99 | 1 |
| Ocrelizumab 30 mg/ml intravenous solution HCPCS J2350 | $54,942.65 | $68,678.31 | $134.33 – $184.31 | 2 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $83.61 | $104.51 | $1.36 – $1.87 | 2 |
| Octreotide,microspheres ER 20 mg intramuscular susp, extended release HCPCS J2353 | $16,831.86 | $21,039.83 | $477.45 – $655.06 | 2 |
| Ocular instrumnt screen bil CPT 99174 | $9.60 | $12.00 | not published | 0 |
| Ocular instrumnt screen bil CPT 99177 | $8.00 | $10.00 | not published | 0 |
| Ocular photodynamic ther CPT 67221 | not published | not published | $1,731.92 – $1,731.92 | 1 |
| Ocular reconst transplant CPT 65780 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Ocular reconst transplant CPT 65781 | not published | not published | $13,037.66 – $13,037.66 | 1 |
| Ocular reconst transplant CPT 65782 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Off base opioid tx, 60 m HCPCS G2087 | not published | not published | $475.42 – $475.42 | 1 |
| Off base opioid tx 70min HCPCS G2086 | not published | not published | $475.42 – $475.42 | 1 |
| Off/op cnsltj new/est low 30 CPT 99243 | $174.40 | $218.00 | not published | 0 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $260.00 | $325.00 | not published | 0 |
| Off/op consltj new/est hi 55 CPT 99245 | $380.80 | $476.00 | not published | 0 |
| Off/op consltj new/est sf 20 CPT 99242 | $127.20 | $159.00 | not published | 0 |
| Olanzapine 10 mg intramuscular solution HCPCS J2359 | $205.06 | $256.33 | $2.05 – $2.81 | 2 |
| Olanzapine long-acting inj HCPCS J2358 | $3,104.46 | $3,880.58 | $6.56 – $9.00 | 2 |
| Ol dig e/m svc 11-20 min CPT 99422 | $44.00 | $55.00 | not published | 0 |
| Ol dig e/m svc 21+ min CPT 99423 | $69.60 | $87.00 | not published | 0 |
| Ol dig e/m svc 5-10 min CPT 99421 | $22.40 | $28.00 | not published | 0 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $2,023.53 | $2,529.41 | $91.27 – $125.22 | 2 |
| Onc breast mrna 12 genes CPT 81522 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc breast mrna 58 genes CPT 81520 | not published | not published | $3,137.76 – $7,749.02 | 2 |
| Onc breast mrna 70 genes CPT 81521 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc brst mrna 11 genes CPT 81518 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc brst mrna 70 cnt 31 gene CPT 81523 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc cutan mlnma mrna 31 gene CPT 81529 | not published | not published | $8,991.25 – $22,204.79 | 2 |
| Oncology colon mrna CPT 81525 | $2,132.80 | $2,666.00 | $3,895.00 – $9,619.09 | 2 |
| Oncology colorectal scr CPT 81528 | $1,633.60 | $2,042.00 | $636.09 – $1,570.88 | 2 |
| Oncology gynecologic CPT 81535 | $1,919.20 | $2,399.00 | $724.33 – $1,788.79 | 2 |
| Oncology gynecologic CPT 81536 | $562.40 | $703.00 | $221.95 – $548.13 | 2 |
| Oncology lung CPT 81538 | $649.60 | $812.00 | $3,588.75 – $8,862.78 | 2 |
| Oncology prostate prob score CPT 81539 | not published | not published | $950.00 – $2,346.12 | 2 |
| Oncology tissue of origin CPT 81504 | not published | not published | $650.00 – $1,605.24 | 2 |
| Oncology tum unknown origin CPT 81540 | $4,752.00 | $5,940.00 | $4,687.50 – $11,576.25 | 2 |
| Onco (ovar) five proteins CPT 81503 | not published | not published | $1,121.25 – $2,769.04 | 2 |
| Onco (ovar) two proteins CPT 81500 | not published | not published | $325.63 – $804.16 | 2 |
| Oncoprotein dcp CPT 83951 | not published | not published | $80.51 – $198.83 | 2 |
| Oncoprotein her-2/neu CPT 83950 | not published | not published | $80.51 – $198.83 | 2 |
| Onc prostate 3 genes CPT 81551 | not published | not published | $2,537.50 – $6,266.61 | 2 |
| Onc prostate mrna 22 cnt gen CPT 81542 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc prostate mrna 46 genes CPT 81541 | not published | not published | $4,841.25 – $11,955.95 | 2 |
| Onc thyr mrna 10,196 gen alg CPT 81546 | not published | not published | $4,500.00 – $11,113.20 | 2 |
| Onc uveal mlnma mrna 15 gene CPT 81552 | not published | not published | $9,720.00 – $24,004.51 | 2 |
| Ondansetron 4 mg s0119 HCPCS S0119 | $0.80 | $1.00 | not published | 0 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $45.82 | $57.28 | $0.03 – $0.04 | 2 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $67.70 | $84.62 | $0.21 – $0.28 | 2 |
| Oocyte identification CPT 89254 | not published | not published | $513.12 – $513.12 | 1 |
| Open bx/exc inguinofem nodes CPT 38531 | not published | not published | $11,217.60 – $11,217.60 | 1 |
| Open nasoethmoid fx with fixj CPT 21339 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Open nasoethmoid fx without fixj CPT 21338 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Open periprosthetic breast capsule 19370 CPT 19370 | not published | not published | $11,217.60 – $11,217.60 | 1 |
| Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Open thrombectomy of av fistula without revision 36831 CPT 36831 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Open tx compl front sinus fx CPT 21344 | $2,055.20 | $2,569.00 | not published | 0 |
| Open tx nose fx w/skele fixj CPT 21330 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Open tx nose & septal fx CPT 21335 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Open tx rib 1-3 fx w/fix 21811 CPT 21811 | $871.20 | $1,089.00 | $21,583.67 – $21,583.67 | 1 |
| Open tx rib 4-6 fx w/fix 21812 CPT 21812 | $1,056.00 | $1,320.00 | $21,583.67 – $21,583.67 | 1 |
| Open tx rib 7+ fx w/fix 21813 CPT 21813 | $1,448.00 | $1,810.00 | $4,680.86 – $4,680.86 | 1 |
| Ophthalmic biometry CPT 92136 | not published | not published | $378.88 – $378.88 | 1 |
| Ophthalmodynamometry CPT 92260 | not published | not published | $110.81 – $110.81 | 1 |
| Ophth Ultrasound b & quant a CPT 76510 | not published | not published | $378.88 – $378.88 | 1 |
| Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 | not published | not published | $348.75 – $348.75 | 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.