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 |
|---|---|---|---|---|
| Benign lesion paring 2-4 CPT 11056 | $123.20 | $154.00 | $589.25 – $589.25 | 1 |
| Benign lesion paring 4+ CPT 11057 | $132.00 | $165.00 | $589.25 – $589.25 | 1 |
| #_benzodiazconfur CPT 80346 | $114.40 | $143.00 | not published | 0 |
| Benztropine 1 mg/ml injection solution HCPCS J0515 | not published | not published | $38.85 – $53.30 | 2 |
| Beta 2 glycoprotein 1 antibody iga CPT 86146 | $59.20 | $74.00 | $31.81 – $78.56 | 2 |
| Beta-2 microglobulin CPT 82232 | $148.80 | $186.00 | $20.23 – $49.95 | 2 |
| Betamethasone acetate and sodium phos 6 mg/ml suspension for injection HCPCS J0702 | $95.46 | $119.32 | $15.50 – $21.27 | 2 |
| Bevacizumab 25 mg/ml intravenous solution HCPCS J9035 | $4,186.80 | $5,233.50 | $164.36 – $225.50 | 2 |
| Bevacizumab-awwb 25 mg/ml intravenous solution HCPCS Q5107 | $3,309.21 | $4,136.51 | $64.91 – $89.05 | 2 |
| Bevacizumab-bvzr 25 mg/ml intravenous solution HCPCS Q5118 | $2,284.82 | $2,856.03 | $53.84 – $73.87 | 2 |
| B-hexosaminidase ea assay CPT 83080 | $69.60 | $87.00 | $21.09 – $52.08 | 2 |
| Bilateral n blobk inj pudendal 64430 CPT 64430 | $146.40 | $183.00 | $2,780.68 – $2,780.68 | 1 |
| Bilateral n block inj occipital 64405 CPT 64405 | $111.20 | $139.00 | $887.20 – $887.20 | 1 |
| Bilateral n block inj trigeminal 64400 CPT 64400 | $168.80 | $211.00 | $887.20 – $887.20 | 1 |
| Bile acids cholylglycine CPT 82240 | not published | not published | $33.23 – $82.05 | 2 |
| Biliary endo perq dx w/speci CPT 47552 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Biliary endoscopy thru skin CPT 47553 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Biliary endoscopy thru skin CPT 47554 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Biliary endoscopy thru skin CPT 47555 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Biliary endoscopy thru skin CPT 47556 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Bilicheck CPT 88720 | $26.40 | $33.00 | $6.28 – $15.50 | 2 |
| Bilirubin direct CPT 82248 | $43.20 | $54.00 | $6.28 – $15.50 | 2 |
| Bilirubin total CPT 82247 | $52.80 | $66.00 | $6.28 – $15.50 | 2 |
| Biopsy abdominal mass CPT 49180 | $1,320.00 | $1,650.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy arm/elbow soft tissue CPT 24066 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy, bone open deep CPT 20245 | $510.40 | $638.00 | $8,429.22 – $8,429.22 | 1 |
| Biopsy bone trocar/needle superficial CPT 20220 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Biopsy cervixsingle/multiple 57500 CPT 57500 | $233.60 | $292.00 | $2,295.45 – $2,295.45 | 1 |
| Biopsy conjunctiva CPT 68100 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Biopsy/excision of lymph node(s); open deep 38530 CPT 38530 | not published | not published | $11,217.60 – $11,217.60 | 1 |
| Biopsy external ear 69100 CPT 69100 | $143.20 | $179.00 | $678.14 – $678.14 | 1 |
| Biopsy eyelid & lid margin CPT 67810 | $268.80 | $336.00 | $863.77 – $863.77 | 1 |
| Biopsy eye muscle CPT 67346 | not published | not published | $11,405.88 – $11,405.88 | 1 |
| Biopsy finger joint lining CPT 26105 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy finger joint lining CPT 26110 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Biopsy forearm soft tissues CPT 25066 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy hand joint lining CPT 26100 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) CPT 38222 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy knee joint lining CPT 27330 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy lower leg soft tissue CPT 27613 | $375.20 | $469.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy lower leg soft tissue 27610 CPT 27610 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy muscle percutaneous needle CPT 20206 | $747.20 | $934.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy needle liver percutaneous CPT 47000 | $882.40 | $1,103.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy needle lymph node superficial CPT 38505 | $977.60 | $1,222.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy of cornea CPT 65410 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Biopsy of epididymis CPT 54800 | not published | not published | $4,893.07 – $4,893.07 | 1 |
| Biopsy of foot joint lining CPT 28050 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy of foot joint lining CPT 28052 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy of heart lining CPT 93505 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Biopsy of hip joint CPT 27052 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Biopsy of inestine 44100 CPT 44100 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Biopsy of lip 40490 CPT 40490 | $181.60 | $227.00 | $678.14 – $678.14 | 1 |
| Biopsy of nail unit 11755 CPT 11755 | $180.80 | $226.00 | $2,117.62 – $2,117.62 | 1 |
| Biopsy of nerve CPT 64795 | not published | not published | $5,865.36 – $5,865.36 | 1 |
| Biopsy of ovary(s) 58900 CPT 58900 | not published | not published | $9,225.99 – $9,225.99 | 1 |
| Biopsy of penis CPT 54105 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy of penis 54100 CPT 54100 | $299.20 | $374.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy of prostate CPT 55700 | $358.40 | $448.00 | $6,052.50 – $6,052.50 | 1 |
| Biopsy of prostate CPT 55705 | $358.40 | $448.00 | $10,458.39 – $10,458.39 | 1 |
| Biopsy of rectum wall anal approach 45100 CPT 45100 | $445.60 | $557.00 | $8,384.23 – $8,384.23 | 1 |
| Biopsy of sacroiliac joint CPT 27050 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Biopsy of salivary gland 42400 CPT 42400 | not published | not published | $2,117.62 – $2,117.62 | 1 |
| Biopsy of salivary glnd;incisional 42405 CPT 42405 | not published | not published | $4,529.52 – $4,529.52 | 1 |
| Biopsy of tear gland CPT 68510 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Biopsy of tear sac CPT 68525 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Biopsy of testis CPT 54500 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy of testis CPT 54505 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Biopsy of toe joint lining CPT 28054 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy of upper nose/throat CPT 42804 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Biopsy of urethra CPT 53200 | $239.20 | $299.00 | $6,052.50 – $6,052.50 | 1 |
| Biopsy of wrist joint CPT 25100 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biopsy oocyte polar body CPT 89291 | not published | not published | $513.12 – $513.12 | 1 |
| Biopsy oocyte polar body <=5 CPT 89290 | not published | not published | $513.12 – $513.12 | 1 |
| Biopsy/removal lymph nodes CPT 38525 | $652.80 | $816.00 | $11,217.60 – $11,217.60 | 1 |
| Biopsy/removal lymph nodes 38520 CPT 38520 | not published | not published | $11,217.60 – $11,217.60 | 1 |
| Biopsy renal percutaneous trocar/needle (both sides) CPT 50200 | $1,434.40 | $1,793.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy roof of mouth CPT 42100 | $216.80 | $271.00 | $4,529.52 – $4,529.52 | 1 |
| Biopsy skin incisional single lesion CPT 11106 | $232.80 | $291.00 | $1,895.66 – $1,895.66 | 1 |
| Biopsy/soft tissue/neck or thorax 21550 CPT 21550 | $394.40 | $493.00 | $4,893.07 – $4,893.07 | 1 |
| Biopsy thigh soft tissues CPT 27324 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Biopsy tongue anterior two-thirds CPT 41100 | $280.00 | $350.00 | $1,490.61 – $1,490.61 | 1 |
| Biopsy vaginal mucosa xtnsv CPT 57105 | $265.60 | $332.00 | $9,225.99 – $9,225.99 | 1 |
| Biopsy vestibule of mouth 40808 CPT 40808 | $251.20 | $314.00 | $1,490.61 – $1,490.61 | 1 |
| Biopsy vrt bdy open lmbr/crv CPT 20251 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Biopsy vrt bdy open thoracic CPT 20250 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Biospy of bladder CPT 53899 | $96.80 | $121.00 | $701.12 – $701.12 | 1 |
| Biotinidase - quest CPT 82261 | not published | not published | $21.09 – $52.08 | 2 |
| Bis xtracell fluid analysis CPT 93702 | not published | not published | $474.53 – $474.53 | 1 |
| Bivalirudin HCPCS J0583 | not published | not published | $0.37 – $0.51 | 2 |
| Bladder irrigate/lavage/instill 51700 CPT 51700 | $113.60 | $142.00 | $701.12 – $701.12 | 1 |
| Bld exchange truj oth thn nb CPT 36455 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Bld prd mix CPT 86965 | not published | not published | $513.12 – $513.12 | 1 |
| Bld push tfuj 2 yr/< CPT 36440 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Bleomycin 15 unit solution for injection HCPCS J9040 | not published | not published | $47.02 – $64.52 | 2 |
| Blepharoplasty lower 15820 CPT 15820 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Blepharoplasty upper 15822 CPT 15822 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Blepharoplasty upper eyelid 15823 CPT 15823 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Blepharp lwr eyelid fat pad CPT 15821 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Blinatumomab 35 mcg intravenous solution HCPCS J9039 | not published | not published | $367.21 – $503.82 | 2 |
| Blind cor sinus reducer impl HCPCS C9783 | not published | not published | $34,638.00 – $34,638.00 | 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.