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Providence St Joseph Medical Center

6 13Th Ave E, Polson, MT 59860 · (406) 883-5377

Critical Access HospitalsVoluntary non-profit - Private

Price file

Prices published

File dated 2026-04-01

2,794 price rows for 69 procedures

Published prices

cash · negotiated range · list
Basic metabolic panel (blood test)

CPT 80048 · lowest of 5 lines

$65
cash
$1,159
cash
CT scan of the head, no contrast

CPT 70450 · lowest of 6 lines

$764
cash
CT scan of the pelvis, with contrast

CPT 72193 · lowest of 6 lines

$1,104
cash
—
cash
$3,297
cash
—
cash
Chlamydia test (DNA)

CPT 87491 · lowest of 41 lines

$6
cash
Colonoscopy (diagnostic)

CPT 45378 · lowest of 8 lines

$268
cash
Colonoscopy with biopsy

CPT 45380 · lowest of 3 lines

$291
cash
Colonoscopy with polyp removal

CPT 45385 · lowest of 3 lines

$370
cash
Complete blood count (CBC) with differential

CPT 85025 · lowest of 24 lines

$2
cash
Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 8 lines

$11
cash
Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 4 lines

$314
cash
$22
cash
$211
cash
Family psychotherapy with the patient

CPT 90847 · lowest of 8 lines

$146
cash
Family psychotherapy without the patient

CPT 90846 · lowest of 7 lines

$140
cash
Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 2 lines

$981
cash
Gonorrhea test (DNA)

CPT 87591 · lowest of 38 lines

$6
cash
Group psychotherapy

CPT 90853 · lowest of 9 lines

$34
cash
—
cash
—
cash
—
cash
Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 5 lines

$777
cash
Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 2 lines

$960
cash
—
cash
$5,903
cash
Lipid panel (cholesterol test)

CPT 80061 · lowest of 50 lines

$6
cash
Liver function panel

CPT 80076 · lowest of 5 lines

$62
cash
MRI of the brain, with and without contrast

CPT 70553 · lowest of 6 lines

$2,817
cash
$1,724
cash
$1,957
cash
MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 9 lines

$1,691
cash
—
cash
$146
cash
New patient office visit (about 30 minutes)

CPT 99203 · lowest of 6 lines

$115
cash
New patient office visit (about 45 minutes)

CPT 99204 · lowest of 6 lines

$196
cash
New patient office visit (about 60 minutes)

CPT 99205 · lowest of 6 lines

$255
cash
PSA test (prostate)

CPT 84153 · lowest of 31 lines

$3
cash
$6
cash
$55
cash
Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 7 lines

$200
cash
Preventive visit, new patient age 18 to 39

CPT 99385 · lowest of 5 lines

$141
cash
Preventive visit, new patient age 40 to 64

CPT 99386 · lowest of 5 lines

$170
cash
Prostate biopsy

CPT 55700 · lowest of 4 lines

$358
cash
—
cash
Prothrombin time (blood clotting test)

CPT 85610 · lowest of 32 lines

$6
cash
Psychotherapy, 30 minutes

CPT 90832 · lowest of 9 lines

$99
cash
Psychotherapy, 45 minutes

CPT 90834 · lowest of 9 lines

$130
cash
Psychotherapy, 60 minutes

CPT 90837 · lowest of 9 lines

$191
cash
Removal of a breast lump (biopsy by excision)

CPT 19120 · lowest of 4 lines

$617
cash
Screening mammogram (both breasts)

CPT 77067 · lowest of 9 lines

$280
cash
Shoulder arthroscopy with decompression

CPT 29826 · lowest of 2 lines

$254
cash
Sleep study (overnight, attended)

CPT 95810 · lowest of 6 lines

$934
cash
—
cash
$176
cash
$138
cash
TSH test (thyroid)

CPT 84443 · lowest of 39 lines

$4
cash
Tonsils and adenoids removal (under age 12)

CPT 42820 · lowest of 2 lines

$427
cash
Transvaginal ultrasound

CPT 76830 · lowest of 7 lines

$175
cash
Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 6 lines

$431
cash
Upper endoscopy (EGD)

CPT 43235 · lowest of 6 lines

$178
cash
Upper endoscopy with biopsy

CPT 43239 · lowest of 6 lines

$201
cash
Urinalysis with microscope

CPT 81001 · lowest of 15 lines

$23
cash
Vaginal delivery after a previous cesarean

CPT 59610 · lowest of 2 lines

$3,066
cash
—
cash
$2,909
cash
X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 5 lines

$198
cash

Source files

The machine-readable files this hospital lists in its cms-hpt.txt. Every price above comes from one of them.