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 |
|---|---|---|---|---|
| Oth resp proc, group HCPCS G0239 | $66.40 | $83.00 | $110.81 – $110.81 | 1 |
| Oth resp proc, indiv HCPCS G0238 | $66.40 | $83.00 | $81.43 – $81.43 | 1 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $46.40 | $58.00 | not published | 0 |
| Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes CPT 97760 | $84.80 | $106.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $66.40 | $83.00 | not published | 0 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $43.20 | $54.00 | not published | 0 |
| Otoplasty 69300 CPT 69300 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Ot re-evaluation patient/family CPT 97168 | $92.80 | $116.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $48.80 | $61.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes CPT 97130 | $29.60 | $37.00 | not published | 0 |
| Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes CPT 97129 | $30.40 | $38.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $68.00 | $85.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $55.20 | $69.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $84.80 | $106.00 | not published | 0 |
| Ovarian cystectomy 58925 CPT 58925 | $1,136.00 | $1,420.00 | $15,124.47 – $15,124.47 | 1 |
| Ovulation tests CPT 84830 | not published | not published | $15.88 – $39.20 | 2 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | not published | not published | $1.85 – $2.54 | 2 |
| Oxaliplatin 5 mg/ml desensitization HCPCS J9263 | $366.28 | $457.85 | $0.20 – $0.28 | 2 |
| Oxytocin 10 unit/ml injection solution HCPCS J2590 | $77.18 | $96.48 | not published | 0 |
| Pabpn1 gene detc abnor allel CPT 81312 | not published | not published | $171.25 – $422.92 | 2 |
| Paclitaxel 6 mg/ml concentrate,intravenous HCPCS J9267 | $212.46 | $265.58 | $0.24 – $0.33 | 2 |
| Paclitaxel protein-bound 100 mg intravenous suspension HCPCS J9264 | $1,911.73 | $2,389.66 | $27.27 – $37.42 | 2 |
| Palb2 gene full gene seq CPT 81307 | not published | not published | $845.63 – $2,088.36 | 2 |
| Palb2 gene known famil vrnt CPT 81308 | not published | not published | $376.69 – $930.27 | 2 |
| Palifermin injection HCPCS J2425 | not published | not published | $80.81 – $110.87 | 2 |
| Palingen or palingen xplus HCPCS Q4173 | not published | not published | $802.25 – $1,100.68 | 2 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $12.00 | $15.00 | $33.94 – $46.56 | 2 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $1,664.80 | $2,081.00 | not published | 0 |
| Palonosetron hcl HCPCS J2469 | not published | not published | $1.00 – $1.37 | 2 |
| Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution HCPCS J2430 | $97.17 | $121.46 | $25.11 – $34.45 | 2 |
| Panitumumab 20 mg/ml intravenous solution (wrapper) HCPCS J9303 | not published | not published | $388.24 – $532.66 | 2 |
| Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr HCPCS J2470 | $82.18 | $102.72 | not published | 0 |
| Parathormone (pth) intact CPT 83970 | $212.80 | $266.00 | $51.60 – $127.43 | 2 |
| Parathyrd planar w/spect&ct CPT 78072 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Parathyroid planar imaging CPT 78070 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Parathyroid planar img w/tomo spect CPT 78071 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Paravaginal defect repair 57284 CPT 57284 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Parial mast w/lymph removal 19302 CPT 19302 | $1,364.00 | $1,705.00 | $19,392.63 – $19,392.63 | 1 |
| Paricalcitol HCPCS J2501 | not published | not published | $1.51 – $2.07 | 2 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $107.20 | $134.00 | $589.25 – $589.25 | 1 |
| Parotid duct diversion CPT 42507 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Parotid duct diversion CPT 42509 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Parotid duct diversion CPT 42510 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Part exc/post vert comp/sng/thorac 22101 CPT 22101 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | $304.80 | $381.00 | $9,225.99 – $9,225.99 | 1 |
| Partial exc bone humerus CPT 24140 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | $865.60 | $1,082.00 | $9,712.92 – $9,712.92 | 1 |
| Partial excision of lip CPT 40500 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Partial hip replacement CPT 27125 | $1,664.00 | $2,080.00 | not published | 0 |
| Partial hysterectomy CPT 58180 | $1,414.40 | $1,768.00 | not published | 0 |
| Partial removal finger bone CPT 26235 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Partial removal finger bone CPT 26236 | $654.40 | $818.00 | $4,680.86 – $4,680.86 | 1 |
| Partial removal foot fascia CPT 28060 | $768.00 | $960.00 | $9,712.92 – $9,712.92 | 1 |
| Partial removal leg bone(s) CPT 27360 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of eye fluid CPT 67005 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Partial removal of eye fluid CPT 67010 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Partial removal of fibula CPT 27641 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of foot bone CPT 28288 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of hand bone CPT 26230 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of lip CPT 40530 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Partial removal of nose CPT 30150 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Partial removal of penis CPT 54120 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Partial removal of pharynx 42890 CPT 42890 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Partial removal of radius CPT 25151 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of radius CPT 25230 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of rectum CPT 45111 | $1,600.00 | $2,000.00 | not published | 0 |
| Partial removal of rib CPT 21600 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Partial removal of thyroid CPT 60220 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Partial removal of thyroid CPT 60225 | $1,409.60 | $1,762.00 | $17,007.37 – $17,007.37 | 1 |
| Partial removal of tibia CPT 27640 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of toe CPT 28160 | $603.20 | $754.00 | $9,712.92 – $9,712.92 | 1 |
| Partial removal of tongue CPT 41120 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Partial removal of ulna CPT 25119 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of ulna CPT 25150 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of ulna CPT 25240 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Partial removal of vaginal wall 57106 CPT 57106 | not published | not published | $9,225.99 – $9,225.99 | 1 |
| Partial removal tear gland CPT 68505 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Partial thyroid excision CPT 60210 | $1,065.60 | $1,332.00 | $17,007.37 – $17,007.37 | 1 |
| Partial thyroid lobect w/contratlat stot lobec 60212 CPT 60212 | $1,539.20 | $1,924.00 | $17,007.37 – $17,007.37 | 1 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | not published | not published | $5.75 – $7.89 | 2 |
| Part removal of metatarsal CPT 28110 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Part removal of metatarsal CPT 28113 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Part removal of metatarsal 28112 CPT 28112 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Path clin consltj high 41-60 CPT 80505 | not published | not published | $513.12 – $513.12 | 1 |
| Path clin consltj mod 21-40 CPT 80504 | not published | not published | $513.12 – $513.12 | 1 |
| Path clin consltj sf 5-20 CPT 80503 | not published | not published | $163.59 – $163.59 | 1 |
| Pathogen reduced plasma pool HCPCS P9070 | $116.00 | $145.00 | $238.24 – $238.24 | 1 |
| Pathogen reduced plasma sing HCPCS P9071 | $116.00 | $145.00 | $290.10 – $290.10 | 1 |
| Patient recorded spirometry CPT 94014 | not published | not published | $1,232.01 – $1,232.01 | 1 |
| Patient recorded spirometry CPT 94015 | not published | not published | $913.84 – $913.84 | 1 |
| Pca3/klk3 antigen CPT 81313 | not published | not published | $318.81 – $787.34 | 2 |
| Pcv21 vaccine im CPT 90684 | not published | not published | $737.76 – $1,012.21 | 2 |
| Pdgfra gene CPT 81314 | $1,009.60 | $1,262.00 | $411.89 – $1,017.20 | 2 |
| Pdt dstr prmlg les phys/qhp CPT 96573 | $326.40 | $408.00 | $589.25 – $589.25 | 1 |
| Pedcle fh/ch/ch/m/n/ax/g/h/f CPT 15574 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Ped crit care transport CPT 99466 | $340.80 | $426.00 | not published | 0 |
| Ped home apnea mntr att only CPT 94775 | not published | not published | $474.53 – $474.53 | 1 |
| Ped home apnea mntr dl&alys CPT 94776 | not published | not published | $474.53 – $474.53 | 1 |
| Pedicle enel/ntroral 15576 CPT 15576 | $1,173.60 | $1,467.00 | $5,631.53 – $5,631.53 | 1 |
| Pegaspargase injection HCPCS J9266 | not published | not published | $63,954.13 – $87,745.07 | 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.