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 |
|---|---|---|---|---|
| Retrograde ejaculation anal CPT 89331 | not published | not published | $24.49 – $60.47 | 2 |
| Revasc intra lithotrip-ather HCPCS C9766 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revasc intra lithotrip-stent HCPCS C9765 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revasc intravasc lithotripsy HCPCS C9764 | not published | not published | $34,638.00 – $34,638.00 | 1 |
| Revasc lithotr-ather tib/per HCPCS C9774 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revasc lithotrip-stent-ather HCPCS C9767 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revasc lithotrip tibi/perone HCPCS C9772 | not published | not published | $34,638.00 – $34,638.00 | 1 |
| Revasc lithotr-stent tib/per HCPCS C9773 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revasc lith-sten-ath tib/per HCPCS C9775 | not published | not published | $56,050.90 – $56,050.90 | 1 |
| Revefenacin inh non-com 1mcg HCPCS J7677 | not published | not published | $0.43 – $0.59 | 2 |
| Revise abdomen-venous shunt CPT 49426 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Revise aqueous shunt eye CPT 66185 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Revise arm/leg nerve CPT 64708 | $740.80 | $926.00 | $5,865.36 – $5,865.36 | 1 |
| Revise breast reconst 19380 CPT 19380 | not published | not published | $19,392.63 – $19,392.63 | 1 |
| Revise eye CPT 65091 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise eyelashes CPT 67825 | not published | not published | $863.77 – $863.77 | 1 |
| Revise eyelashes CPT 67835 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eyelid defect CPT 67909 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eyelid defect CPT 67911 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eyelid lining CPT 68330 | not published | not published | $7,046.29 – $7,046.29 | 1 |
| Revise eyelid lining CPT 68360 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise eyelid lining CPT 68362 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eye muscle CPT 67311 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eye muscle CPT 67314 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eye muscle(s) CPT 67318 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise eye socket implant CPT 67560 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise eye sockets CPT 21260 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise eye sockets CPT 21261 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise eye sockets CPT 21263 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise eye sockets CPT 21267 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise eye with implant CPT 65093 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise finger joint each CPT 26135 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise finger joint each CPT 26140 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Revise gastric port open 43886 CPT 43886 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Revise/graft eyelid lining CPT 68320 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise/graft eyelid lining CPT 68325 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise/graft eyelid lining CPT 68326 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise/graft eyelid lining CPT 68328 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise/graft eyelid lining CPT 68335 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise graft w/vein CPT 35879 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Revise graft w/vein 35881 CPT 35881 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Revise hand/finger tendon CPT 26390 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise head/neck of femur CPT 27179 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise hernia & sperm veins CPT 55540 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Revise/implant finger joint CPT 26536 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise kneecap CPT 27437 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise kneecap with implant CPT 27438 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Revise knuckle joint CPT 26530 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise knuckle with implant CPT 26531 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise low back nerve(s) CPT 64714 | not published | not published | $5,865.36 – $5,865.36 | 1 |
| Revise lower leg tendon CPT 27690 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise lower leg tendon CPT 27691 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise lower leg tendons CPT 27686 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise middle ear bone CPT 69660 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear bone CPT 69661 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear bone CPT 69662 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid CPT 69641 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid CPT 69642 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid CPT 69643 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid CPT 69644 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid CPT 69646 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise middle ear & mastoid 69645 CPT 69645 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Revise ocular implant CPT 65125 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise ocular implant CPT 65150 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise palsy hand tendon(s) CPT 25315 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise palsy hand tendon(s) CPT 25316 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise penis/urethra CPT 54328 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Revise penis/urethra CPT 54332 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Revise penis/urethra CPT 54336 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Revise prosth vag graft lap CPT 57426 | not published | not published | $22,598.24 – $22,598.24 | 1 |
| Revise radius or ulna CPT 25370 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise radius & ulna CPT 25365 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Revise radius & ulna CPT 25375 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise reconst elbow joint CPT 24370 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Revise reconst elbow joint CPT 24371 | not published | not published | $71,452.46 – $71,452.46 | 1 |
| Revise/remove neuroelectrode CPT 61880 | not published | not published | $10,597.24 – $10,597.24 | 1 |
| Revise/remove neuroreceiver CPT 61888 | not published | not published | $39,001.55 – $39,001.55 | 1 |
| Revise/remove sling repair CPT 57287 | $1,098.40 | $1,373.00 | $9,225.99 – $9,225.99 | 1 |
| Revise/replace knee joint CPT 27486 | $2,061.60 | $2,577.00 | not published | 0 |
| Revise/repl vagus n eltrd CPT 64569 | not published | not published | $39,001.55 – $39,001.55 | 1 |
| Revise spermatic cord veins CPT 55530 | $530.40 | $663.00 | $10,458.39 – $10,458.39 | 1 |
| Revise spermatic cord veins CPT 55535 | $646.40 | $808.00 | $11,557.38 – $11,557.38 | 1 |
| Revise spine eltrd perq aray CPT 63663 | not published | not published | $21,548.51 – $21,548.51 | 1 |
| Revise spine eltrd plate CPT 63664 | not published | not published | $39,001.55 – $39,001.55 | 1 |
| Revise thigh muscles/tendons CPT 27400 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revise thumb tendon CPT 26490 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise thumb tendon CPT 26496 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise two eye muscles CPT 67312 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Revise two eye muscles CPT 67316 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Revise ulnar nerve at wrist CPT 64719 | $601.60 | $752.00 | $5,865.36 – $5,865.36 | 1 |
| Revise ureter CPT 50727 | $765.60 | $957.00 | $10,458.39 – $10,458.39 | 1 |
| Revise urethra stage 1 CPT 53400 | not published | not published | $15,343.31 – $15,343.31 | 1 |
| Revise urethra stage 2 CPT 53405 | not published | not published | $15,343.31 – $15,343.31 | 1 |
| Revise vag graft via vagina CPT 57295 | $742.40 | $928.00 | $9,225.99 – $9,225.99 | 1 |
| Revise windpipe scar CPT 31830 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Revise wrist/forearm tendon CPT 25280 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Revise wrist joint CPT 25332 | $1,286.40 | $1,608.00 | $9,712.92 – $9,712.92 | 1 |
| Revision of amputation CPT 24935 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revision of ankle joint CPT 27700 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Revision of aqueous shunt CPT 66184 | not published | not published | $7,046.29 – $7,046.29 | 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.