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 |
|---|---|---|---|---|
| Treat wrist bone fracture CPT 25635 | not published | not published | $4,680.86 – $4,680.86 | 1 |
| Treat wrist dislocation CPT 25675 | not published | not published | $675.49 – $675.49 | 1 |
| Tremelimumab-actl 20 mg/ml intravenous solution HCPCS J9347 | not published | not published | $317.62 – $435.78 | 2 |
| Treponema pallidum ag if CPT 87285 | not published | not published | $15.23 – $37.60 | 2 |
| Treponema pallidum antibody CPT 86780 | $89.60 | $112.00 | $16.55 – $40.87 | 2 |
| Treprostinil injection HCPCS J3285 | not published | not published | $124.84 – $171.28 | 2 |
| Treprostinil, non-comp unit HCPCS J7686 | not published | not published | $1,800.34 – $2,470.07 | 2 |
| Trg gene rearrangement anal CPT 81342 | not published | not published | $251.88 – $622.03 | 2 |
| Trh stimulation panel CPT 80439 | not published | not published | $84.01 – $207.48 | 2 |
| Triamcinolone acetonide 40 mg/ml suspension for injection HCPCS J3301 | $81.03 | $101.29 | $1.94 – $2.66 | 2 |
| Triamcinolone a inj prs-free HCPCS J3300 | not published | not published | $55.14 – $75.66 | 2 |
| Trichinella antibody CPT 86784 | $68.00 | $85.00 | $15.70 – $38.77 | 2 |
| Trichomonas assay w/optic CPT 87808 | not published | not published | $19.11 – $47.20 | 2 |
| Triglycerides CPT 84478 | $54.40 | $68.00 | $7.18 – $17.72 | 2 |
| Trilaciclib 300 mg intravenous solution HCPCS J1448 | not published | not published | $12.13 – $16.65 | 2 |
| Trimethobenzamide hcl inj HCPCS J3250 | not published | not published | $120.15 – $164.85 | 2 |
| Trim nail(s) HCPCS G0127 | $34.40 | $43.00 | $187.55 – $187.55 | 1 |
| Trim nondyst nails CPT 11719 | $20.80 | $26.00 | $187.55 – $187.55 | 1 |
| Triptorelin pamoate HCPCS J3315 | not published | not published | $1,106.77 – $1,518.49 | 2 |
| Trluml dil aq o/f can without st CPT 66174 | not published | not published | $13,037.66 – $13,037.66 | 1 |
| Trluml dil aq o/f can w/st CPT 66175 | not published | not published | $13,037.66 – $13,037.66 | 1 |
| Trml dstrj ios bvn 1st 2 l/s CPT 64628 | not published | not published | $42,576.18 – $42,576.18 | 1 |
| Trmt of fracture (femoral shaft) 27500 CPT 27500 | not published | not published | $675.49 – $675.49 | 1 |
| Trnscath plc vas stent w/s&i ini vein CPT 37238 | not published | not published | $34,638.00 – $34,638.00 | 1 |
| Trnscath retrv pq vasc fb w/guide CPT 37197 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Trnscath tx thromblytc artery non-intracrn ini day CPT 37211 | not published | not published | $16,771.14 – $16,771.14 | 1 |
| Trnscath tx thromblytc art/ven sbsq day CPT 37213 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Trnscath tx thromblytc cath rmv sbsq day CPT 37214 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Trnscath tx thromblytc vein ini day CPT 37212 | not published | not published | $9,720.46 – $9,720.46 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss any area 30.1-60sqcm CPT 14301 | not published | not published | $10,614.75 – $10,614.75 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< CPT 14060 | $1,152.80 | $1,441.00 | $5,631.53 – $5,631.53 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss eye/nose/ear/lip 10.1-30sqcm CPT 14061 | $1,496.80 | $1,871.00 | $5,631.53 – $5,631.53 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss sclp/arm/lg 10.1-30sqcm CPT 14021 | $1,305.60 | $1,632.00 | $5,631.53 – $5,631.53 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10.1-30sqcm CPT 14001 | $1,189.60 | $1,487.00 | $5,631.53 – $5,631.53 | 1 |
| Trnsfr/rearrngmnt adjcnt tiss trnk 10sqcm/< CPT 14000 | $957.60 | $1,197.00 | $5,631.53 – $5,631.53 | 1 |
| Trnsplj pd lvr&bwl cd154+cll CPT 81560 | not published | not published | $800.91 – $1,977.93 | 2 |
| Trnspl rej kdn mrna qpcr 139 CPT 81558 | not published | not published | $4,050.00 – $10,001.88 | 2 |
| Troponin quantitative CPT 84484 | $124.80 | $156.00 | $15.59 – $38.49 | 2 |
| Tr retinal les preterm inf CPT 67229 | not published | not published | $1,731.92 – $1,731.92 | 1 |
| Trurl dstrj prst8 tiss rf wv CPT 53854 | not published | not published | $10,458.39 – $10,458.39 | 1 |
| Tte w or without contr, cont ecg HCPCS C8930 | $1,011.20 | $1,264.00 | $2,417.07 – $2,417.07 | 1 |
| Tte w or without fol w/con,stres HCPCS C8928 | $1,011.20 | $1,264.00 | $2,417.07 – $2,417.07 | 1 |
| Tte w or without fol w/cont, com HCPCS C8921 | $1,011.20 | $1,264.00 | $2,417.07 – $2,417.07 | 1 |
| Tte w or without fol w/cont, f/u HCPCS C8922 | $1,011.20 | $1,264.00 | $2,417.07 – $2,417.07 | 1 |
| Tubal Ligation (Laparoscopic) CPT 58670 | $550.40 | $688.00 | $17,007.37 – $17,007.37 | 1 |
| Tumor cell deplete of harvst CPT 38211 | not published | not published | $1,330.51 – $1,330.51 | 1 |
| Tvh >250 gms 58290 CPT 58290 | $1,700.80 | $2,126.00 | $22,598.24 – $22,598.24 | 1 |
| Tvh w/mmk 58267 CPT 58267 | $1,582.40 | $1,978.00 | not published | 0 |
| Tx atrial fib pulm vein isol CPT 93656 | not published | not published | $76,619.96 – $76,619.96 | 1 |
| Tx closed distal humerus fx CPT 24999 | not published | not published | $675.49 – $675.49 | 1 |
| Tx closed hip disl traumatic without anes CPT 27250 | $264.80 | $331.00 | $675.49 – $675.49 | 1 |
| Tx closed tib fx proximal w/w/o manip w/skel trac CPT 27532 | $920.80 | $1,151.00 | $9,712.92 – $9,712.92 | 1 |
| Tx closed tib shaft fx without manip CPT 27750 | $544.80 | $681.00 | $675.49 – $675.49 | 1 |
| Tx contour defects >10.0 cc CPT 11954 | not published | not published | $1,895.66 – $1,895.66 | 1 |
| Tx contour defects 1.1-5.0cc 11951 CPT 11951 | $164.00 | $205.00 | $1,895.66 – $1,895.66 | 1 |
| Tx ectopic pregnancy abdl pregnancy 59130 CPT 59130 | $1,400.80 | $1,751.00 | not published | 0 |
| Tx open art fx mcp/iphlngl jnt incl int fixtn ea CPT 26746 | $1,096.00 | $1,370.00 | $9,712.92 – $9,712.92 | 1 |
| Tx open dstl phlngl fx f/t internal fixation ea CPT 26765 | $743.20 | $929.00 | $9,712.92 – $9,712.92 | 1 |
| Tx open iphlngl jt disl internal fixation sngl CPT 26785 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Tx open nsl fx uncomp CPT 21325 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Tx open nsl sptl fx CPT 21336 | not published | not published | $9,712.92 – $9,712.92 | 1 |
| Tx phalangeal shaft fx open prox/middle ea CPT 26735 | $879.20 | $1,099.00 | $9,712.92 – $9,712.92 | 1 |
| Tx septic abortion surgical 59830 CPT 59830 | $696.00 | $870.00 | not published | 0 |
| Tx tarsal bone fx without manip 28450 CPT 28450 | not published | not published | $675.49 – $675.49 | 1 |
| Tympanic membrane repair CPT 69610 | $567.20 | $709.00 | $4,529.52 – $4,529.52 | 1 |
| Tympanolysis transcanal 69450 CPT 69450 | not published | not published | $9,283.38 – $9,283.38 | 1 |
| Tympanometry & reflex thresh CPT 92550 | $32.80 | $41.00 | $474.53 – $474.53 | 1 |
| Tympanostomy/ven tube/loc/top anes 69433 CPT 69433 | $300.00 | $375.00 | $1,490.61 – $1,490.61 | 1 |
| Tympp antrt/mastoidotomy prosthesis torp 69637 CPT 69637 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Tympp antrt/mastoid without ossic chain recnst 69635 CPT 69635 | not published | not published | $17,423.47 – $17,423.47 | 1 |
| Tyms gene com variants CPT 81346 | not published | not published | $218.51 – $539.64 | 2 |
| U2af1 gene common variants CPT 81357 | not published | not published | $241.56 – $596.56 | 2 |
| Ua w/micro/comp poc CPT 81000 | $19.20 | $24.00 | $5.03 – $12.41 | 2 |
| Ublituximab-xiiy 25 mg/ml intravenous solution HCPCS J2329 | not published | not published | $161.78 – $221.97 | 2 |
| Ugt1a1 gene analy common variants CPT 81350 | not published | not published | $292.50 – $722.36 | 2 |
| Ultrasound abdomen aorta screening study aaa CPT 76706 | $287.20 | $359.00 | $348.75 – $348.75 | 1 |
| Ultrasound bone density measure CPT 76977 | not published | not published | $348.75 – $348.75 | 1 |
| Ultrasound breast complete CPT 76641 | $187.20 | $234.00 | $348.75 – $348.75 | 1 |
| Ultrasound breast unilateral limited (both sides) CPT 76642 | $187.20 | $234.00 | $283.48 – $283.48 | 1 |
| Ultrasound chest CPT 76604 | $477.60 | $597.00 | $348.75 – $348.75 | 1 |
| Ultrasound doppler velocimetry fetal umbilical artery CPT 76820 | $104.80 | $131.00 | $348.75 – $348.75 | 1 |
| Ultrasound dx ophth b-scan CPT 76512 | not published | not published | $348.75 – $348.75 | 1 |
| Ultrasound elastography parenchyma CPT 76981 | $396.00 | $495.00 | $348.75 – $348.75 | 1 |
| Ultrasound encephalogram CPT 76506 | $187.20 | $234.00 | $348.75 – $348.75 | 1 |
| Ultrasound exam k transpl w/doppler CPT 76776 | $508.00 | $635.00 | $348.75 – $348.75 | 1 |
| Ultrasound fetal biophysical profile without non-stress testing CPT 76819 | $466.40 | $583.00 | $348.75 – $348.75 | 1 |
| Ultrasound guidance for vascular access CPT 76937 | $497.60 | $622.00 | not published | 0 |
| Ultrasound guided needle placement supervision & interpretation CPT 76942 | $455.20 | $569.00 | not published | 0 |
| Ultrasound guide intraoperative CPT 76998 | $657.60 | $822.00 | not published | 0 |
| Ultrasound hips infant dynamic CPT 76885 | $414.40 | $518.00 | $283.48 – $283.48 | 1 |
| Ultrasound infant hips ltd without stress CPT 76886 | $178.40 | $223.00 | $283.48 – $283.48 | 1 |
| Ultrasound joint complete left CPT 76881 | $292.80 | $366.00 | $348.75 – $348.75 | 1 |
| Ultrasound joint/nonvascular extremity limited left CPT 76882 | $191.20 | $239.00 | $348.75 – $348.75 | 1 |
| Ultrasound nrv&acc strux 1xtr compre CPT 76883 | not published | not published | $348.75 – $348.75 | 1 |
| Ultrasound ob >=14wks ea addl gest CPT 76810 | $284.80 | $356.00 | not published | 0 |
| Ultrasound pregnant uterus < 14 weeks each additional gestation CPT 76802 | $208.80 | $261.00 | not published | 0 |
| Ultrasound pregnant uterus detailed fetal exam single/1st gestation CPT 76811 | $853.60 | $1,067.00 | $761.98 – $761.98 | 1 |
| Ultrasound pregnant uterus follow up per fetus CPT 76816 | $340.80 | $426.00 | $348.75 – $348.75 | 1 |
| Ultrasound pregnant uterus limited >= 1 fetuses CPT 76815 | $280.80 | $351.00 | $348.75 – $348.75 | 1 |
| Ultrasound pregnant uterus transvaginal CPT 76817 | $544.00 | $680.00 | $348.75 – $348.75 | 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.