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 |
|---|---|---|---|---|
| Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln HCPCS J9311 | not published | not published | $83.16 – $114.10 | 2 |
| Rituximab-abbs 10 mg/ml intravenous solution HCPCS Q5115 | $3,324.88 | $4,156.10 | $70.16 – $96.25 | 2 |
| Rituximab-arrx 10 mg/ml intravenous solution HCPCS Q5123 | not published | not published | $67.31 – $92.35 | 2 |
| Rituximab-pvvr 10 mg/ml intravenous solution HCPCS Q5119 | not published | not published | $59.63 – $81.81 | 2 |
| R&l hrt cath chd abnl nt cnj CPT 93597 | not published | not published | $9,653.52 – $9,653.52 | 1 |
| R&l hrt cath chd nml nt cnj CPT 93596 | not published | not published | $9,653.52 – $9,653.52 | 1 |
| Rmv implant contraceptive capsule 11976 CPT 11976 | $212.80 | $266.00 | $2,117.62 – $2,117.62 | 1 |
| Rmvl esophgl sphnctr dev CPT 43285 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Rmvl ext fixj sys under anes CPT 20694 | $652.80 | $816.00 | $4,680.86 – $4,680.86 | 1 |
| Rmvl fb upr arm/elbow deep CPT 24201 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rmvl fecal impaction/fb spx under anes CPT 45915 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Rmvl foreign body upper arm/elbow subcutaneous CPT 24200 | $333.60 | $417.00 | $4,893.07 – $4,893.07 | 1 |
| Rmvl hpglsl nstim ary pg CPT 64584 | not published | not published | $20,161.06 – $20,161.06 | 1 |
| Rmvl icd by tv extr CPT 33244 | not published | not published | $10,934.15 – $10,934.15 | 1 |
| Rmvl icd gen w/rplc icd gen dual lead sys CPT 33263 | not published | not published | $74,456.69 – $74,456.69 | 1 |
| Rmvl icd gen w/rplc icd gen mlt lead sys CPT 33264 | not published | not published | $104,665.75 – $104,665.75 | 1 |
| Rmvl icd gen w/rplc icd gen sgl lead sys CPT 33262 | not published | not published | $74,456.69 – $74,456.69 | 1 |
| Rmvl icd pulse gen only CPT 33241 | not published | not published | $10,934.15 – $10,934.15 | 1 |
| Rmvl ndwellg tun pleural cath CPT 32552 | not published | not published | $1,887.67 – $1,887.67 | 1 |
| Rmvl perm pm pulse gen CPT 33233 | not published | not published | $26,635.30 – $26,635.30 | 1 |
| Rmvl pm gen w/rplc pm gen mlt lead sys CPT 33229 | not published | not published | $60,927.18 – $60,927.18 | 1 |
| Rmvl pm gen w/rplc pm gen sgl lead sys CPT 33227 | not published | not published | $26,635.30 – $26,635.30 | 1 |
| Rmvl prosthhumrl&ulnar cmpnt CPT 24160 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Rmvl sq defib electrode CPT 33272 | not published | not published | $10,934.15 – $10,934.15 | 1 |
| Rmvl subq card rhythm mntr CPT 33286 | $190.40 | $238.00 | $2,117.62 – $2,117.62 | 1 |
| Rmvl tiss expndr without implant insrtn CPT 11971 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Rmvl tongs/halo anthr indiv CPT 20665 | $179.20 | $224.00 | $1,232.01 – $1,232.01 | 1 |
| Rmvl tv pm lead dual CPT 33235 | not published | not published | $10,934.15 – $10,934.15 | 1 |
| Rmvl tv pm lead sgl CPT 33234 | not published | not published | $10,934.15 – $10,934.15 | 1 |
| Rmv ntr oi implt skl prq esp CPT 69726 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Rmv ntr oi imp sk tc>=100 CPT 69728 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Rmv ntr oi imp sk tc esp<100 CPT 69727 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Rolapitant, oral, 1mg HCPCS J8670 | not published | not published | $3.51 – $4.81 | 2 |
| Romidepsin 10 mg/2 ml intravenous powder for solution HCPCS J9319 | not published | not published | $69.92 – $95.93 | 2 |
| Romiplostim 125 mcg subcutaneous solution HCPCS J2802 | $7,384.31 | $9,230.39 | $24.74 – $33.94 | 2 |
| Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper) HCPCS J3111 | $7,054.43 | $8,818.04 | $27.01 – $37.06 | 2 |
| Ropivacaine 0.2 % epidural pca - 1 hour dose limit HCPCS J2795 | $84.59 | $105.74 | $0.14 – $0.19 | 2 |
| Rotavirus antibody CPT 86759 | not published | not published | $22.79 – $56.28 | 2 |
| Routine footcare pt w lops HCPCS G0247 | $124.00 | $155.00 | $589.25 – $589.25 | 1 |
| Rozanolixizumab-noli 140 mg/ml subcutaneous solution HCPCS J9333 | not published | not published | $52.11 – $71.50 | 2 |
| Rplcm oi implt sk tc esp<100 CPT 69719 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Rplcmt oi implt skl prq esp CPT 69717 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Rplc oi implt sk tc esp>=100 CPT 69730 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Rpl non-tun cvc wo sbq prt/pmp CPT 36580 | not published | not published | $4,854.90 – $4,854.90 | 1 |
| Rp loclzj tum 2+area 1+d img CPT 78801 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Rp loclzj tum spect w/ct 1 CPT 78830 | not published | not published | $4,330.91 – $4,330.91 | 1 |
| Rp loclzj tum spect w/ct 2 CPT 78832 | not published | not published | $4,859.78 – $4,859.78 | 1 |
| Rpl picc wo subq port/pump incl image guidnc w/s&i CPT 36584 | not published | not published | $4,854.90 – $4,854.90 | 1 |
| Rpl tun-cvad w subq port CPT 36582 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Rpl tun-cvad w subq pump CPT 36583 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Rpl tun cvc wo subq port CPT 36581 | $1,204.80 | $1,506.00 | $9,720.46 – $9,720.46 | 1 |
| Rpm tx mgmt 1st 20 min CPT 99457 | $73.60 | $92.00 | not published | 0 |
| Rpm tx mgmt ea addl 20 min CPT 99458 | $59.20 | $74.00 | not published | 0 |
| Rpr aa hrn 1st > 10 rdc CPT 49595 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr aa hrn 1st 3-10 ncr/strn CPT 49594 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Rpr aa hrn 1st 3-10 rdc CPT 49593 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr aa hrn 1st < 3 cm rdc CPT 49591 | $508.80 | $636.00 | $11,557.38 – $11,557.38 | 1 |
| Rpr aa hrn 1st < 3 ncr/strn CPT 49592 | $712.00 | $890.00 | $17,007.37 – $17,007.37 | 1 |
| Rpr aa hrn rcr 3-10 rdc CPT 49615 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr aa hrn rcr < 3 ncr/strn CPT 49614 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Rpr aa hrn rcr < 3 rdc CPT 49613 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr blood ves w/vein graft/up ext 35236 CPT 35236 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Rpr blood vsl grf oth vein lo ex CPT 35286 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Rpr choanal atresia ntranasl CPT 30540 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rpr choanal atresia trsnpltn CPT 30545 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rpr fem hernia init blocked CPT 49553 | $940.00 | $1,175.00 | $11,557.38 – $11,557.38 | 1 |
| Rpr hern preemie reduc CPT 49491 | not published | not published | $17,007.37 – $17,007.37 | 1 |
| Rpr hypspad comp dsj & urtp CPT 54348 | not published | not published | $15,343.31 – $15,343.31 | 1 |
| Rpr hypspad comp simple CPT 54340 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Rpr ing hernia baby blocked CPT 49496 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr ing hernia baby reduc CPT 49495 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr ing hernia init blocked CPT 49501 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr ing hernia init reduce CPT 49500 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr ing hern premie blocked CPT 49492 | not published | not published | $11,557.38 – $11,557.38 | 1 |
| Rpr nsl vlv collapse w/implt CPT 30468 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rpr nsl vlv collapse w/rmdlg CPT 30469 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Rpr&refit spct prsth aphakia CPT 92371 | not published | not published | $187.55 – $187.55 | 1 |
| Rpr rem hernia init reduce CPT 49550 | $856.80 | $1,071.00 | $11,557.38 – $11,557.38 | 1 |
| Rpr xtnsr tndn leg prim without grft ea tndn CPT 27664 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Rp therapy unlisted px CPT 79999 | not published | not published | $814.87 – $814.87 | 1 |
| Rrp hypspad comp moblj&urtp CPT 54344 | not published | not published | $27,923.42 – $27,923.42 | 1 |
| Rsv assay w/optic CPT 87807 | not published | not published | $16.38 – $40.44 | 2 |
| Rtm 1st set-up&pt educaj eqp CPT 98975 | not published | not published | $394.38 – $394.38 | 1 |
| Rtm dev sply cbt 16-30 d CPT 98978 | not published | not published | $114.22 – $114.22 | 1 |
| Rtm dev sply mscskl 16-30 d CPT 98977 | not published | not published | $114.22 – $114.22 | 1 |
| Rtm dev sply resp sys 16-30d CPT 98976 | not published | not published | $114.22 – $114.22 | 1 |
| Rubella antibody igg CPT 86762 | $102.40 | $128.00 | $17.99 – $44.42 | 2 |
| Rubeola ag if CPT 87283 | not published | not published | $76.00 – $187.69 | 2 |
| Rubeola antibody igg CPT 86765 | $79.20 | $99.00 | $16.10 – $39.76 | 2 |
| Runx1 gene targeted seq alys CPT 81334 | not published | not published | $411.89 – $1,017.20 | 2 |
| Russell viper venom diluted CPT 85613 | $125.60 | $157.00 | $11.98 – $29.57 | 2 |
| Rx metab gen seq alys pnl 6 CPT 81418 | not published | not published | $1,146.35 – $2,831.03 | 2 |
| Sacituzumab govitecan-hziy 180 mg intravenous solution HCPCS J9317 | $3,300.88 | $4,126.10 | $81.58 – $111.93 | 2 |
| Salivary gland function exam CPT 78232 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Salivary gland imaging CPT 78230 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Salivary glnd img serial img CPT 78231 | not published | not published | $1,268.29 – $1,268.29 | 1 |
| Salmonella antibody CPT 86768 | not published | not published | $16.49 – $40.72 | 2 |
| Salpingostomy 58770 CPT 58770 | not published | not published | $9,225.99 – $9,225.99 | 1 |
| Same day nb discharge 99463 CPT 99463 | $160.00 | $200.00 | $394.38 – $394.38 | 1 |
| Sargramostim injection HCPCS J2820 | not published | not published | $126.20 – $173.15 | 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.