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 |
|---|---|---|---|---|
| Pt application of modality >=1 area iontophoresis each 15 minutes CPT 97033 | $37.60 | $47.00 | not published | 0 |
| Pt application of modality >=1 area ultrasound each 15 minutes CPT 97035 | $68.00 | $85.00 | not published | 0 |
| Pt application of modality traction mechanical CPT 97012 | $65.60 | $82.00 | not published | 0 |
| Pt/caregiver traing home inr CPT 93792 | $102.40 | $128.00 | not published | 0 |
| Pten gene dup/delet variant CPT 81323 | not published | not published | $375.00 – $926.10 | 2 |
| Pten gene full sequence CPT 81321 | not published | not published | $750.00 – $1,852.20 | 2 |
| Pten gene known fam variant CPT 81322 | not published | not published | $58.25 – $143.85 | 2 |
| Pterygomaxillary fossa surg any appr 31040 CPT 31040 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Pt evaluation high complexity patient/family CPT 97163 | $153.60 | $192.00 | not published | 0 |
| Pt evaluation low complexity patient/family CPT 97161 | $92.80 | $116.00 | not published | 0 |
| Pt evaluation moderate complexity patient/family CPT 97162 | $123.20 | $154.00 | not published | 0 |
| Pt-focused hlth risk assmt CPT 96160 | $4.80 | $6.00 | $96.85 – $96.85 | 1 |
| Pt init/spiromet rec/review/interp 94016 CPT 94016 | $36.00 | $45.00 | not published | 0 |
| Pt re-evaluation patient/family CPT 97164 | $123.20 | $154.00 | not published | 0 |
| Pt repositioning canalith procedure(s) per day CPT 95992 | $68.00 | $85.00 | not published | 0 |
| Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan HCPCS G0283 | $80.00 | $100.00 | not published | 0 |
| Pt therapeutic procedure >=1 area gait training each 15 minutes CPT 97116 | $58.40 | $73.00 | not published | 0 |
| Pt therapeutic procedure >=1 area massage each 15 minutes CPT 97124 | $68.00 | $85.00 | not published | 0 |
| Pt wheelchair management each 15 minutes CPT 97542 | $52.00 | $65.00 | not published | 0 |
| Pul art balloon repr percut CPT 92997 | not published | not published | $34,638.00 – $34,638.00 | 1 |
| Pulm ds ipf mrna 190 gen alg CPT 81554 | not published | not published | $6,806.25 – $16,808.72 | 2 |
| Pulmonary vent imaging CPT 78579 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Pulse ox continuous overnight monitoring CPT 94762 | $178.40 | $223.00 | $474.53 – $474.53 | 1 |
| Pulse ox multiple CPT 94761 | $120.00 | $150.00 | not published | 0 |
| Pulse ox single CPT 94760 | $5.60 | $7.00 | not published | 0 |
| Punc of shunt for asp or inj CPT 61070 | not published | not published | $2,102.48 – $2,102.48 | 1 |
| Puncture arterial withdrawal blood for diagnosis CPT 36600 | $152.00 | $190.00 | $378.88 – $378.88 | 1 |
| Puncture aspiration abscess/hematoma/bulla/cyst CPT 10160 | $516.00 | $645.00 | $1,217.32 – $1,217.32 | 1 |
| Puncture/clear windpipe 31612 CPT 31612 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Puncture spinal lumbar diagnostic CPT 62270 | $363.20 | $454.00 | $2,102.48 – $2,102.48 | 1 |
| Puraply 1 sq cm HCPCS Q4195 | not published | not published | $242.81 – $333.14 | 2 |
| Puraply xt 1 sq cm HCPCS Q4197 | not published | not published | $159.83 – $219.29 | 2 |
| Pvb thoracic 2nd+ inj site CPT 64462 | $1,214.40 | $1,518.00 | not published | 0 |
| Pvb thoracic cont infusion CPT 64463 | $1,214.40 | $1,518.00 | $2,102.48 – $2,102.48 | 1 |
| Pvb thoracic single inj site CPT 64461 | $1,214.40 | $1,518.00 | $2,102.48 – $2,102.48 | 1 |
| Pyloroplasty 43800 CPT 43800 | $1,379.20 | $1,724.00 | not published | 0 |
| Pyridoxine hcl 100 mg HCPCS J3415 | not published | not published | $28.80 – $39.51 | 2 |
| Pyruvate CPT 84210 | $53.60 | $67.00 | $18.10 – $44.70 | 2 |
| Pyruvate kinase CPT 84220 | $40.80 | $51.00 | $11.80 – $29.14 | 2 |
| Quan puplmtry phy/qhp uni/bi CPT 95919 | $24.00 | $30.00 | $378.88 – $378.88 | 1 |
| Quant diff pulm perf and vent w/imaging CPT 78598 | not published | not published | $1,646.19 – $1,646.19 | 1 |
| Quant diff pulm perf w/imaging CPT 78597 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Quest t3 uptake CPT 84479 | $118.40 | $148.00 | $8.09 – $19.97 | 2 |
| Rabies ig ht&sol human im/sc CPT 90377 | not published | not published | $533.48 – $731.93 | 2 |
| Rabies immune globulin (pf) 300 unit/ml intramuscular solution CPT 90375 | $1,257.52 | $1,571.90 | $599.48 – $822.49 | 2 |
| Radiation physics consult CPT 77336 | not published | not published | $435.21 – $435.21 | 1 |
| Radiation therapy dose plan CPT 77300 | not published | not published | $435.21 – $435.21 | 1 |
| Radiation treatment aid(s) CPT 77332 | not published | not published | $435.21 – $435.21 | 1 |
| Radiation treatment aid(s) CPT 77333 | not published | not published | $435.21 – $435.21 | 1 |
| Radiation treatment aid(s) CPT 77334 | not published | not published | $1,170.51 – $1,170.51 | 1 |
| Radiation treatment delivery CPT 77401 | not published | not published | $399.35 – $399.35 | 1 |
| Radiation treatment delivery CPT 77402 | not published | not published | $399.35 – $399.35 | 1 |
| Radiation treatment delivery CPT 77412 | not published | not published | $857.96 – $857.96 | 1 |
| Radical resection of elbow CPT 24149 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Radic resect abd tumor<5cm 22904 CPT 22904 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Radic resect shoulder tumor 5cm/> 23078 CPT 23078 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Radiotherapy dose plan imrt CPT 77301 | not published | not published | $4,374.64 – $4,374.64 | 1 |
| Radphm lcl tmr plnr bdy sgl day img CPT 78802 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Radphm lcl tmr plnr bdy two day img CPT 78804 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Radphm lcl tmr spect/ct 2+ areas/2+ days CPT 78831 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Radphm lcl tomogr sgl area sgl day CPT 78803 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Radphm lcl tumor plr sgl day CPT 78800 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Rad rescj tum dstl/shft hum CPT 24150 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Rad rescj tum shoulder<5 cm CPT 23077 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad rescj tum tiss a/e 5 cm+ CPT 24079 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad rescj tum tiss a/e <5cm CPT 24077 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad resec soft tis tum/ft/toe/<3cm 28046 CPT 28046 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad resect abd tumor 5 cm/> CPT 22905 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad resect hand tumor < 3 cm CPT 26117 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad resect hand tumor 3 cm/> CPT 26118 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rad resection tum radial h/n CPT 24152 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Rad resect tumor/neck/ant thor/<5cm21557 CPT 21557 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Ramucirumab 10 mg/ml intravenous solution HCPCS J9308 | $9,855.65 | $12,319.56 | $167.52 – $229.84 | 2 |
| Ranibizumab injection HCPCS J2778 | not published | not published | $205.00 – $281.26 | 2 |
| Rapid desensitization CPT 95180 | $208.00 | $260.00 | $1,232.01 – $1,232.01 | 1 |
| Rapid Strep Test CPT 87880 | $73.60 | $92.00 | $20.66 – $51.03 | 2 |
| Rasburicase 1.5 mg intravenous solution HCPCS J2783 | not published | not published | $847.08 – $1,162.19 | 2 |
| Ravulizumab-cwvz 100 mg/ml intravenous solution HCPCS J1303 | not published | not published | $506.68 – $695.17 | 2 |
| Rbc count only automated CPT 85041 | not published | not published | $3.78 – $9.32 | 2 |
| Rbc deglycerolized each unit HCPCS P9039 | not published | not published | $1,348.38 – $1,348.38 | 1 |
| Rbc depletion of harvest CPT 38212 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Rbc irradiated each unit HCPCS P9038 | $442.40 | $553.00 | $640.19 – $640.19 | 1 |
| Rbc mechanical fragility CPT 85547 | not published | not published | $10.75 – $26.55 | 2 |
| Rbc osmotic fragility CPT 85555 | not published | not published | $9.34 – $23.06 | 2 |
| Rbc serum pretx incubj drugs CPT 86975 | not published | not published | $1,232.01 – $1,232.01 | 1 |
| Rcnst bfrnt sp orb rm&lw fhd CPT 21175 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rdctj forehead cntrg only CPT 21137 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Rdctj forehead cntrg&prostc CPT 21138 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rdctj forehead cntrg&setback CPT 21139 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Realignment of knee CPT 27457 | $1,416.80 | $1,771.00 | not published | 0 |
| Realignment of tendons CPT 26437 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Rebuild eardrum structures CPT 69632 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rebuild eardrum structures CPT 69633 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rebuild eardrum structures CPT 69636 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rebuild outer ear canal CPT 69310 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rebuild outer ear canal CPT 69320 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Reconst lwr jaw w/fixation CPT 21196 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Reconst lwr jaw w/graft CPT 21194 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Reconst lwr jaw without fixation CPT 21195 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Reconst lwr jaw without graft CPT 21193 | not published | not published | $17,423.47 – $17,423.47 | 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.