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 |
|---|---|---|---|---|
| Sars-cov-2 antb quantitative CPT 86413 | not published | not published | $64.29 – $158.76 | 2 |
| Sarscov2 vac 5mcg/0.5ml im CPT 91304 | $237.12 | $296.40 | $363.46 – $498.67 | 2 |
| Sarscov coronavirus ag ia CPT 87426 | $73.60 | $92.00 | $44.16 – $109.06 | 2 |
| Sarscov & inf vir a&b ag ia CPT 87428 | not published | not published | $87.86 – $216.99 | 2 |
| S bowel endoscope w/stent CPT 44379 | not published | not published | $17,100.59 – $17,100.59 | 1 |
| Sbsq nurs facil care/day unstabl/new prob 35 min 99310 CPT 99310 | $192.00 | $240.00 | not published | 0 |
| Sbsq nursing facil care/day minor complj 15 min CPT 99308 | $99.20 | $124.00 | not published | 0 |
| Sbsq nursing facil care/day new problem 25 min CPT 99309 | $130.40 | $163.00 | not published | 0 |
| Sbsq nursing facility care/day e/m stable 10 min CPT 99307 | $63.20 | $79.00 | not published | 0 |
| Sbsq psyc collab care mgmt CPT 99493 | not published | not published | $247.51 – $247.51 | 1 |
| Scan duplex abd/pelvis/retroperitoneal complete CPT 93975 | $864.00 | $1,080.00 | $761.98 – $761.98 | 1 |
| Scan duplex abd/pelvis/retroperitoneal limited CPT 93976 | $624.80 | $781.00 | $348.75 – $348.75 | 1 |
| Scan duplex aorta/ivc/iliac or bypass grafts complete CPT 93978 | $824.80 | $1,031.00 | $761.98 – $761.98 | 1 |
| Scan duplex aorta/ivc/iliac unilateral/limited CPT 93979 | $636.80 | $796.00 | $348.75 – $348.75 | 1 |
| Scan duplex extracranial arteries unilateral/limited study CPT 93882 | $376.00 | $470.00 | $348.75 – $348.75 | 1 |
| Scan duplex extremity veins unilateral/limited study CPT 93971 | $432.80 | $541.00 | $348.75 – $348.75 | 1 |
| Scan duplex lower extremity arteries complete bilateral CPT 93925 | $716.80 | $896.00 | $761.98 – $761.98 | 1 |
| Scan duplex lower extremity arteries unilateral/limited study left CPT 93926 | $747.20 | $934.00 | $348.75 – $348.75 | 1 |
| Scan duplex upper extremity arteries unilateral/limited study left CPT 93931 | $795.20 | $994.00 | $348.75 – $348.75 | 1 |
| Sclerotherapy fluid collection pq w/img CPT 49185 | $1,564.00 | $1,955.00 | $4,893.07 – $4,893.07 | 1 |
| Scope plantar fasciotomy CPT 29893 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Scr c/v cyto, automated sys HCPCS G0147 | not published | not published | $22.74 – $56.15 | 2 |
| Scr c/v cyto, autosys, rescr HCPCS G0148 | not published | not published | $39.93 – $98.60 | 2 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0144 | not published | not published | $54.96 – $135.74 | 2 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0145 | not published | not published | $33.11 – $81.77 | 2 |
| Scr c/v cyto,thinlayer,rescr HCPCS G0143 | not published | not published | $33.81 – $83.50 | 2 |
| Screen cerv/vag thin layer HCPCS G0123 | not published | not published | $25.33 – $62.54 | 2 |
| Screening Colonoscopy (average risk) HCPCS G0121 | $512.80 | $641.00 | $2,711.70 – $2,711.70 | 1 |
| Screening Colonoscopy (high risk) HCPCS G0105 | $512.00 | $640.00 | $2,711.70 – $2,711.70 | 1 |
| Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations HCPCS G0328 | not published | not published | $22.56 – $55.72 | 2 |
| Screening hepatitis b non-obstetric high risk HCPCS G0499 | not published | not published | $35.34 – $87.27 | 2 |
| Screening hepatitis c antibody high risk HCPCS G0472 | not published | not published | $57.94 – $143.08 | 2 |
| Screening HIV antigen/antibody combination assay HCPCS G0475 | not published | not published | $30.10 – $74.33 | 2 |
| Screening Mammogram CPT 77067 | $283.20 | $354.00 | not published | 0 |
| Screening prostate cancer PSA HCPCS G0103 | not published | not published | $24.14 – $59.61 | 2 |
| Screen pap by tech w md supv HCPCS P3000 | not published | not published | $22.74 – $56.15 | 2 |
| Screen/visual acuity/bilat/quant 99173 CPT 99173 | $4.80 | $6.00 | not published | 0 |
| Sc ther infusion reset pump CPT 96371 | not published | not published | $220.15 – $220.15 | 1 |
| Sedimentation rate erythrocyte automated CPT 85652 | $48.80 | $61.00 | $3.38 – $8.33 | 2 |
| Select picture audiometry CPT 92583 | not published | not published | $187.55 – $187.55 | 1 |
| Self-meas bp 2 readg bid 30d CPT 99474 | $22.40 | $28.00 | not published | 0 |
| Self-meas bp pt educaj/train CPT 99473 | $42.40 | $53.00 | $81.43 – $81.43 | 1 |
| Self-mgmt educ/train 2-4 pt 30min CPT 98961 | $22.40 | $28.00 | not published | 0 |
| Self-mgmt educ/train 5-8 pt 30min CPT 98962 | $16.80 | $21.00 | not published | 0 |
| Semen analysis HCPCS G0027 | not published | not published | $8.13 – $20.07 | 2 |
| Semen analysis presence/motility CPT 89321 | $55.20 | $69.00 | $15.06 – $37.20 | 2 |
| Semen analysis w/count CPT 89310 | $126.40 | $158.00 | $10.76 – $26.58 | 2 |
| Sensorimotor examination CPT 92060 | not published | not published | $187.55 – $187.55 | 1 |
| Sensorineural acuity lvl tst CPT 92575 | not published | not published | $110.81 – $110.81 | 1 |
| Separate eyelid adhesions CPT 68340 | not published | not published | $6,898.76 – $6,898.76 | 1 |
| Sept9 promoter methylation analysis CPT 81327 | not published | not published | $240.00 – $592.70 | 2 |
| Sequestrectomy olecrn proces CPT 24138 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Sequestrectomy radial h/n CPT 24136 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Sequestrectomy shft/dstl hum CPT 24134 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Serial casting application 97139app CPT 97139 | $69.60 | $87.00 | not published | 0 |
| Serpina1 gene CPT 81332 | not published | not published | $54.56 – $134.75 | 2 |
| Set radiation therapy field CPT 77280 | not published | not published | $435.21 – $435.21 | 1 |
| Set radiation therapy field CPT 77285 | not published | not published | $1,170.51 – $1,170.51 | 1 |
| Set radiation therapy field CPT 77290 | not published | not published | $1,170.51 – $1,170.51 | 1 |
| Set-up cardiovert-defibrill CPT 93745 | not published | not published | $902.73 – $902.73 | 1 |
| Sever cranial nerve CPT 64771 | not published | not published | $5,865.36 – $5,865.36 | 1 |
| Sex chromatin identification CPT 88130 | not published | not published | $22.48 – $55.50 | 2 |
| Sex chromatin identification CPT 88140 | not published | not published | $9.99 – $24.67 | 2 |
| Sex transformation f to m CPT 55980 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Sex transformation m to f CPT 55970 | not published | not published | $15,124.47 – $15,124.47 | 1 |
| Sf3b1 gene common variants CPT 81347 | not published | not published | $241.56 – $596.56 | 2 |
| Sgmdsc w/band ligation CPT 45350 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 0.5cm/< CPT 11310 | $173.60 | $217.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 0.6-1.0cm CPT 11311 | $204.00 | $255.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m 1.1-2cm CPT 11312 | $231.20 | $289.00 | $1,217.32 – $1,217.32 | 1 |
| Shave sgl skin lsn f/e/e/n/l/m >2cm CPT 11313 | $269.60 | $337.00 | $1,217.32 – $1,217.32 | 1 |
| Shave sgl skin lsn s/n/h/f/g 0.5cm/< CPT 11305 | $160.00 | $200.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn s/n/h/f/g 0.6-1.0 cm CPT 11306 | $183.20 | $229.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn s/n/h/f/g 1.1-2cm CPT 11307 | $209.60 | $262.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn s/n/h/f/g >2cm CPT 11308 | $217.60 | $272.00 | $1,217.32 – $1,217.32 | 1 |
| Shave sgl skin lsn t/a/l 0.5cm/< CPT 11300 | $152.00 | $190.00 | $1,217.32 – $1,217.32 | 1 |
| Shave sgl skin lsn t/a/l 0.6-1.0cm CPT 11301 | $181.60 | $227.00 | $589.25 – $589.25 | 1 |
| Shave sgl skin lsn t/a/l 1.1-2.0cm CPT 11302 | $205.60 | $257.00 | $589.25 – $589.25 | 1 |
| Shigella antibody CPT 86771 | not published | not published | $30.60 – $75.57 | 2 |
| Sho arthrs dx +- synovial bx CPT 29805 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Sho arthrs srg bicp tenodsis CPT 29828 | $1,350.40 | $1,688.00 | $21,583.67 – $21,583.67 | 1 |
| Sho arthrs srg capsulorraphy CPT 29806 | $1,560.00 | $1,950.00 | $21,583.67 – $21,583.67 | 1 |
| Sho arthrs srg compl synvct CPT 29821 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Sho arthrs srg lmtd dbrdmt CPT 29822 | $800.00 | $1,000.00 | $9,712.92 – $9,712.92 | 1 |
| Sho arthrs srg lss&rescj ads CPT 29825 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Sho arthrs srg prtl synvct CPT 29820 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Sho arthrs srg rmvl loose/fb CPT 29819 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Sho arthrs srg rpr slap les CPT 29807 | $1,521.60 | $1,902.00 | $21,583.67 – $21,583.67 | 1 |
| Sho arthrs srg xtnsv dbrdmt CPT 29823 | $875.20 | $1,094.00 | $9,712.92 – $9,712.92 | 1 |
| Shortening of hand tendon CPT 26479 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Shorten radius or ulna CPT 25390 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Shorten radius & ulna CPT 25392 | not published | not published | $21,583.67 – $21,583.67 | 1 |
| Shoulder Arthroscopy (Rotator Cuff Repair) CPT 29827 | $1,573.60 | $1,967.00 | $21,583.67 – $21,583.67 | 1 |
| Shoulder MRI (with and without contrast) CPT 73223 | $3,167.20 | $3,959.00 | $1,202.18 – $1,202.18 | 1 |
| Shoulder MRI (with contrast) CPT 73222 | $2,511.20 | $3,139.00 | $2,417.07 – $2,417.07 | 1 |
| Shoulder MRI (without contrast) CPT 73221 | $1,850.40 | $2,313.00 | $761.98 – $761.98 | 1 |
| Shoulder prosthesis removal CPT 23334 | not published | not published | $8,429.22 – $8,429.22 | 1 |
| Shoulder X-ray CPT 73030 | $239.20 | $299.00 | $283.48 – $283.48 | 1 |
| Shuntogram nonvascular supervision & interpretation CPT 75809 | not published | not published | $348.75 – $348.75 | 1 |
| Sialidase enzyme assay CPT 87905 | not published | not published | $15.28 – $37.72 | 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.