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 |
|---|---|---|---|---|
| Sialography s&i CPT 70390 | not published | not published | $761.98 – $761.98 | 1 |
| Sialolithotomy 42330 CPT 42330 | $346.40 | $433.00 | $9,283.38 – $9,283.38 | 1 |
| Sickling rbc CPT 85660 | $21.60 | $27.00 | $6.89 – $17.01 | 2 |
| Sigmoidoscopy and biopsy CPT 45331 | $439.20 | $549.00 | $2,711.70 – $2,711.70 | 1 |
| Sigmoidoscopy flex decompression 45337 CPT 45337 | not published | not published | $2,711.70 – $2,711.70 | 1 |
| Sigmoidoscopy for bleeding CPT 45334 | $762.40 | $953.00 | $3,533.55 – $3,533.55 | 1 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | not published | not published | $2,711.70 – $2,711.70 | 1 |
| Sigmoidoscopy w/ablation CPT 45346 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $155.20 | $194.00 | $3,533.55 – $3,533.55 | 1 |
| Sigmoidoscopy w/plcmt stent CPT 45347 | not published | not published | $17,100.59 – $17,100.59 | 1 |
| Sigmoidoscopy w/resection CPT 45349 | not published | not published | $8,384.23 – $8,384.23 | 1 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $176.80 | $221.00 | $3,533.55 – $3,533.55 | 1 |
| Sigmoidoscopy w/ultrasound CPT 45341 | not published | not published | $2,711.70 – $2,711.70 | 1 |
| Sigmoidoscopy w/us guide bx CPT 45342 | not published | not published | $3,533.55 – $3,533.55 | 1 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $504.80 | $631.00 | $2,711.70 – $2,711.70 | 1 |
| Signal avg ecg w or without ecg 93278 CPT 93278 | not published | not published | $187.55 – $187.55 | 1 |
| Sig w/tndsc balloon dilation CPT 45340 | $710.40 | $888.00 | $3,533.55 – $3,533.55 | 1 |
| Simple cystometrogram 51725 CPT 51725 | $308.80 | $386.00 | $701.12 – $701.12 | 1 |
| Sincalide 5 mcg solution for injection HCPCS J2805 | not published | not published | $305.94 – $419.75 | 2 |
| Single energy x-ray study HCPCS G0130 | not published | not published | $348.75 – $348.75 | 1 |
| Sinus CT scan (with and without contrast) CPT 70488 | $1,202.40 | $1,503.00 | $588.44 – $588.44 | 1 |
| Sinus CT scan (with contrast) CPT 70487 | $1,076.00 | $1,345.00 | $588.44 – $588.44 | 1 |
| Sinus CT scan (without contrast) CPT 70486 | $799.20 | $999.00 | $348.75 – $348.75 | 1 |
| Sinus/juglr venogram s&i CPT 75860 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Sinusotomy maxillary sinus 31020 CPT 31020 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Sinusotomy sinus remove polyps 31032 CPT 31032 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Sinusotomy sphenoid w/wo bx 31050 CPT 31050 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Sipuleucel-t - su HCPCS Q2043 | not published | not published | $125,878.43 – $172,705.21 | 2 |
| Sirolimus, oral HCPCS J7520 | not published | not published | $2.15 – $2.95 | 2 |
| Sirolimus-protein bound 100 mg intravenous suspension HCPCS J9331 | not published | not published | $190.19 – $260.94 | 2 |
| Skin and muscle repair face CPT 15845 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Skin Biopsy CPT 11102 | $152.00 | $190.00 | $589.25 – $589.25 | 1 |
| Skin full graft 20sq cm less 15200 CPT 15200 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Skin pedicle flap arms/legs CPT 15572 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Skin pedicle flap trunk CPT 15570 | not published | not published | $5,631.53 – $5,631.53 | 1 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $280.80 | $351.00 | not published | 0 |
| Skin test unlisted antigen ea CPT 86486 | $80.00 | $100.00 | $81.43 – $81.43 | 1 |
| Skyla, 13.5 mg HCPCS J7301 | $839.20 | $1,049.00 | not published | 0 |
| Slco1b1 gene com variants CPT 81328 | not published | not published | $218.51 – $539.64 | 2 |
| Sleep study attended CPT 95807 | $1,223.20 | $1,529.00 | $1,577.43 – $1,577.43 | 1 |
| Sleep Study (Polysomnography) CPT 95810 | $1,616.80 | $2,021.00 | $3,048.91 – $3,048.91 | 1 |
| Sleep study unattended CPT 95806 | $358.40 | $448.00 | $474.53 – $474.53 | 1 |
| Sleeve fing rolyan med HCPCS L3933 | $164.80 | $206.00 | not published | 0 |
| Slitting of prepuce CPT 54000 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Slitting of prepuce CPT 54001 | $291.20 | $364.00 | $6,052.50 – $6,052.50 | 1 |
| Slp eval non-spch gen comm dev CPT 92605 | $90.40 | $113.00 | not published | 0 |
| Slp pure tone screening CPT 92551 | $19.20 | $24.00 | not published | 0 |
| Slp stdy unatnd w/anal CPT 95801 | not published | not published | $378.88 – $378.88 | 1 |
| Small animal inoculation CPT 87003 | not published | not published | $21.05 – $51.99 | 2 |
| Small bowel endoscopy CPT 44360 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44364 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44366 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44369 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44376 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44378 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy CPT 44382 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Small bowel endoscopy CPT 44384 | not published | not published | $10,639.72 – $10,639.72 | 1 |
| Small bowel endoscopy >2nd w/remove 44363 CPT 44363 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy 44365 CPT 44365 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy/biopsy CPT 44361 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy/biopsy CPT 44377 | not published | not published | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy br/wa CPT 44380 | not published | not published | $2,693.66 – $2,693.66 | 1 |
| Small bowel endoscopy br/wa CPT 44381 | $1,371.20 | $1,714.00 | $5,682.83 – $5,682.83 | 1 |
| Small bowel endoscopy/stent 44370 CPT 44370 | not published | not published | $17,100.59 – $17,100.59 | 1 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $81.60 | $102.00 | $6.74 – $16.64 | 2 |
| Smear gram stain CPT 87205 | $66.40 | $83.00 | $5.34 – $13.18 | 2 |
| Smear nasal eosinophil CPT 89190 | $83.20 | $104.00 | $7.24 – $17.87 | 2 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $109.60 | $137.00 | $7.49 – $18.49 | 2 |
| Smear wet mount CPT 87210 | $69.60 | $87.00 | $7.28 – $17.97 | 2 |
| Smn1 gene full gene sequence CPT 81336 | not published | not published | $376.69 – $930.27 | 2 |
| Smn1 gen nown famil seq vrnt CPT 81337 | not published | not published | $231.50 – $571.71 | 2 |
| Smpd1 gene common variants CPT 81330 | not published | not published | $58.75 – $145.09 | 2 |
| Snrpn/ube3a gene CPT 81331 | not published | not published | $63.84 – $157.65 | 2 |
| So cap design without jnts cf HCPCS L3671 | $230.40 | $288.00 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $102.40 | $128.00 | $6.33 – $15.62 | 2 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $70.84 | $88.55 | $5.13 – $7.04 | 2 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $77.92 | $97.40 | $3.10 – $4.25 | 2 |
| Sodium chloride 0.9 % IV bolus HCPCS J7050 | $67.30 | $84.12 | $1.60 – $2.19 | 2 |
| Sodium chloride 3 % ivpb HCPCS J7131 | $42.50 | $53.13 | not published | 0 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $179.44 | $224.30 | $4.90 – $6.73 | 2 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $182.40 | $228.00 | $165.12 – $226.55 | 2 |
| Sodium serum/plasma/whole blood CPT 84295 | $35.20 | $44.00 | $6.01 – $14.85 | 2 |
| Sodium thiosulfate 12.5 gram/50 ml (250 mg/ml) intravenous solution HCPCS J0209 | $74.58 | $93.22 | not published | 0 |
| So gsap cl fr cpy nmbr&mcrst CPT 81463 | not published | not published | $1,681.64 – $4,152.97 | 2 |
| So gsap cll fr dna/dna&rna CPT 81462 | not published | not published | $1,494.79 – $3,691.53 | 2 |
| So gsap cll fr mcrstl ins CPT 81464 | not published | not published | $4,110.64 – $10,151.63 | 2 |
| So gsap dna cpy nmbr&mcrstl CPT 81458 | not published | not published | $1,307.94 – $3,230.08 | 2 |
| Somatosensory testing CPT 95927 | not published | not published | $913.84 – $913.84 | 1 |
| So neo gsap dna/dna&rna CPT 81459 | not published | not published | $3,736.94 – $9,228.74 | 2 |
| So neo gsap dna mcrstl ins CPT 81457 | not published | not published | $1,121.09 – $2,768.64 | 2 |
| Special physics consult CPT 77370 | not published | not published | $435.21 – $435.21 | 1 |
| Special radiation dosimetry CPT 77331 | not published | not published | $435.21 – $435.21 | 1 |
| Special radiation treatment CPT 77470 | not published | not published | $1,867.98 – $1,867.98 | 1 |
| Special teletx port plan CPT 77321 | not published | not published | $1,170.51 – $1,170.51 | 1 |
| Specific gravity body fluid CPT 84315 | $35.20 | $44.00 | $4.10 – $10.13 | 2 |
| Specimen fat stain CPT 89125 | $68.00 | $85.00 | $7.35 – $18.15 | 2 |
| Speech audiometry complete CPT 92556 | not published | not published | $187.55 – $187.55 | 1 |
| Speech evaluation complex CPT 70371 | not published | not published | $761.98 – $761.98 | 1 |
| Speech recep thresh CPT 92555 | not published | not published | $110.81 – $110.81 | 1 |
| Sperm antibody test CPT 89325 | not published | not published | $13.34 – $32.94 | 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.