Imaging prices at Providence St. Joseph Medical Center

Polson, MT · every code in this section with a posted price and a Medicare benchmark.

249 codes. Prices are the hospital's own posted facility charges.

Compare against other hospitals interactively →

ProcedurePosted cashPosted gross× Medicare
Abdomen 1 View (74018) $180 $225 2.0×
Abdomen 2 views (74019) $188.80 $236 1.8×
Ankle 2 views (73600)
range across 2 matching MRF lines
$178.40–$179.20 $223–$224 varies
Arthrogram hip (73525) $912.80 $1,141 2.6×
Arthrogram Wrist (73115) $619.20 $774 1.7×
Bone age studies (77072) $293.60 $367 2.7×
Bone survey infant (77076) $218.40 $273 2.0×
Cardiac MRI w/w/o contrast w/stress (75563) $2,260.80 $2,826 2.8×
Chest 1 view (71045) $183.20 $229 2.1×
Chest 2 views (71046) $231.20 $289 2.6×
Chest 3 views (71047) $288.80 $361 3.2×
Chest 4 or more views (71048) $392 $490 3.7×
Clavicle complete (73000) $172.80 $216 1.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $293.60 $367 2.7×
Contrast X-Ray Bladder (74430) $481.60 $602 1.4×
Contrast X-Ray Of Knee Joint (73580) $1,151.20 $1,439 3.2×
CT abdomen and pelvis without and with contrast (74178) $3,709.60 $4,637 10.4×
CT abdomen and pelvis without contrast (74176) $2,518.40 $3,148 10.3×
CT abdomen w contrast (74160) $1,600 $2,000 8.9×
CT abdomen w wo contrast (74170) $1,735.20 $2,169 9.7×
CT abdomen w/o contrast (74150) $1,314.40 $1,643 12.3×
CT Angio Abdomen and Pelvis (74174) $3,628.80 $4,536 10.2×
CT Angio Chest (71275) $1,778.40 $2,223 9.9×
CT Angio Head (70496) $1,233.60 $1,542 6.9×
CT angio hrt w/3d image (75574) $452.80 $566 1.3×
Ct Angio Lwr Extr W/O&W/Dye (73706) $943.20 $1,179 5.3×
CT Angio Neck (70498) $1,364 $1,705 7.6×
Ct Angio Upr Extrm W/O&W/Dye (73206) $2,028 $2,535 11.3×
CT cervical spine w/ contrast (72126) $938.40 $1,173 2.6×
CT cervical spine w/o contrast (72125) $748.80 $936 7.0×
CT cervical spine w/wo cont (72127) $1,160.80 $1,451 6.5×
CT chest w contrast (71260) $1,621.60 $2,027 9.0×
CT chest w/wo contrast (71270) $1,961.60 $2,452 10.9×
CT colonography screening (74263) $935.20 $1,169 3.8×
CT Colonogrphy Dx Image Postprocess W/Contrast (74262) $943.20 $1,179 5.3×
CT colonogrphy dx image postprocess w/o contrast (74261) $542.40 $678 5.1×
CT head/brain with contrast (70460) $1,057.60 $1,322 5.9×
CT head/brain without and with contrast (70470) $1,296 $1,620 7.2×
CT heart no contrast quant eval coronry calcium (75571) $238.40 $298 2.7×
CT iac w contrast (70481) $886.40 $1,108 4.9×
CT l-spine w&w/o contrast (72133) $1,824.80 $2,281 10.2×
CT lower ext w/o (73700) $1,307.20 $1,634 12.2×
CT lower extremity w/contrast material (73701) $1,578.40 $1,973 8.8×
CT lumbar spine w contrast (72132) $1,600 $2,000 4.5×
CT lumbar spine w/o contrast (72131) $1,314.40 $1,643 12.3×
CT maxillofacial w contrast (70487) $1,076 $1,345 6.0×
CT maxillofacial wo contrast (70486) $799.20 $999 7.5×
CT neck tissue combo (70492) $1,142.40 $1,428 6.4×
Ct Orbit/Ear/Fossa W/O&W/Dye (70482) $1,110.40 $1,388 6.2×
CT orbits w/o contrast (70480) $50.40 $63 0.5×
CT pelvis w&w/o contrast (72194) $1,828.80 $2,286 10.2×
CT pelvis w/o contrast (72192) $1,332.80 $1,666 12.5×
CT scan of leg combo (73702) $1,716.80 $2,146 9.6×
CT scans face/jaw combo (70488) $1,202.40 $1,503 6.7×
CT soft tissue neck w contrast (70491) $1,098.40 $1,373 6.1×
CT soft tissue neck w/o contrast (70490) $917.60 $1,147 8.6×
CT thoracic spine w contrast (72129) $1,646.40 $2,058 9.2×
CT thoracic spine w/o contrast (72128) $1,428 $1,785 13.4×
CT thoracic spine w/wo cont (72130) $1,824.80 $2,281 10.2×
CT thorax w/o contrast (71250) $1,380 $1,725 12.9×
CT upper ext wo (73200) $1,345.60 $1,682 12.6×
CT upper extremity w/o & w/contrast material (73202) $1,592 $1,990 8.9×
CT upper extremity with contrast (73201) $1,364.80 $1,706 3.8×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $943.20 $1,179 5.3×
Cta Abdomen (74175) $1,778.40 $2,223 9.9×
CTA head&neck c+ w/noncontrast img&post-pxessing (70471) $238.40 $298 0.7×
CTA pelvis (72191) $1,778.40 $2,223 9.9×
Doppler Fetal Mid Cerebral Artery (76821) $201.60 $252 1.9×
Dxa Bone Density Axial (77080) $55.20 $69 0.5×
Dxa bone density study (77085) $75.20 $94 0.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $95.20 $119 1.1×
Echo exam of fetal heart (76825) $842.40 $1,053 1.5×
Echo exam uterus (76831) $381.60 $477 1.6×
Echo Guide For Artery Repair (76936) $922.40 $1,153 4.2×
Esophagram (74220) $386.40 $483 2.2×
Fetal Biophys Profile W/Nst (76818) $176.80 $221 1.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819)
range across 2 matching MRF lines
$124–$128 $155–$160 varies
Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) $673.60 $842 2.8×
Fluoroscopy up to 1 hr (76000) $452.80 $566 1.9×
Foot 2 views (73620)
range across 2 matching MRF lines
$112.80–$172.80 $141–$216 varies
Forearm 2 views (73090)
range across 2 matching MRF lines
$189.60–$203.20 $237–$254 varies
Gated Heart Planar Single (78472) $307.20 $384 0.8×
Hand 2 views (73120)
range across 2 matching MRF lines
$159.20–$169.60 $199–$212 varies
Ht Muscle Image Spect Sing (78451) $456 $570 0.3×
Hysterosalpingogram (74740) $398.40 $498 1.6×
Infant hip ultrasound with hip movement (dynamic) (76885) $414.40 $518 4.7×
Infant hip ultrasound, limited static exam (76886) $178.40 $223 2.0×
Joint Survey Single View (77077) $121.60 $152 1.1×
Knee 3 Views (73562) $193.60 $242 2.2×
Magnetic Image Jaw Joint (70336) $1,584 $1,980 6.5×
Mra Head W/O & W/Contrast Material (70546) $2,870.40 $3,588 8.1×
MRA head w/o contrast (70544) $1,759.20 $2,199 7.2×
MRA neck w contrast (70548) $1,868.80 $2,336 5.2×
Mra Neck W/O &W/Contrast Material (70549) $2,340.80 $2,926 6.6×
MRA neck w/o contrast (70547) $1,728 $2,160 7.1×
MRI abdomen w contrast (74182) $2,240 $2,800 6.3×
MRI abdomen w/o contrast (74181) $1,623.20 $2,029 6.7×
MRI any jt lower extrem w/contrast material (73722) $1,732.80 $2,166 2.2×
MRI any jt lower extrem w/o & w/contrast matrl (73723) $2,171.20 $2,714 6.1×
MRI any jt upper extremity w/contrast matrl (73222) $2,511.20 $3,139 3.1×
MRI cardiac w/o cont stress (75559) $1,607.20 $2,009 2.9×
MRI cervical spine w contrast (72142) $1,759.20 $2,199 4.9×
MRI cervical spine w/o cont (72141) $1,691.20 $2,114 6.9×
MRI chest w/o contrast (71550) $1,860.80 $2,326 7.6×
MRI chest wo w contrast (71552) $2,800.80 $3,501 7.9×
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) $2,497.60 $3,122 7.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,560.80 $1,951 6.4×
MRI lumbar spine w contrast (72149) $2,448.80 $3,061 6.9×
Mri Neck Spine W/O & W/Dye (72156) $2,776 $3,470 7.8×
MRI orbit face &/neck w/o contrast (70540) $1,449.60 $1,812 5.9×
Mri Orbt/Fac/Nck W/O &W/Dye (70543) $2,639.20 $3,299 7.4×
MRI pelvis w contrast (72196) $1,944 $2,430 5.5×
MRI pelvis w/o & w contrast (72197) $3,043.20 $3,804 8.5×
MRI pelvis w/o contrast (72195) $1,888.80 $2,361 7.7×
MRI thoracic spine w/o contrast (72146) $1,821.60 $2,277 7.5×
MRI upper extremity oth than jt w/contr matrl (73219) $1,850.40 $2,313 5.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $1,558.40 $1,948 6.4×
Mri Uppr Extremity W/O&W/Dye (73220) $2,454.40 $3,068 6.9×
MRI, abdomen, combo (74183) $2,933.60 $3,667 8.2×
MRI, dorsal spine combo (72157) $2,889.60 $3,612 8.1×
MRI, dorsal spine contrast (72147) $1,895.20 $2,369 5.3×
MRI, joint upper extrem (73221) $1,850.40 $2,313 7.6×
MRI, joint upper extrem combo (73223) $3,167.20 $3,959 8.9×
MRI, lumbar spine combo (72158) $2,889.60 $3,612 8.1×
Myelogram cervical (72240) $1,299.20 $1,624 1.6×
Myelogram Lumbar (72265) $1,350.40 $1,688 1.7×
Myelography thoracic (72255) $1,232 $1,540 1.5×
Myelograpy 2/more regions rs&i (72270) $1,942.40 $2,428 2.4×
Myocardial Spect Multiple Studies (78452) $627.20 $784 0.5×
Neck soft tissue (70360) $224.80 $281 2.5×
Ob us nuchal meas 1 gest (76813) $261.60 $327 2.4×
Pelvis 1 or 2 views (72170) $198.40 $248 1.9×
Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) $546.40 $683 5.1×
Radex abscess/fistula/sinus tract rs&i (76080) $632.80 $791 1.1×
Radex Ankle Complete Minimum 3 Views (73610) $238.40 $298 2.7×
Radex Calcaneus Minimum 2 Views (73650) $179.20 $224 2.0×
Radex elbow complete minimum 3 views (73080) $193.60 $242 2.2×
Radex Facial Bones Complete Minimum 3 Views (70150) $455.20 $569 4.3×
Radex fingr minimum 2 views (73140) $236 $295 2.7×
Radex foot complete minimum 3 views (73630) $236 $295 2.7×
Radex Hand Minimum 3 Views (73130) $225.60 $282 2.5×
Radex lower extremity infant minimum 2 views (73592) $193.60 $242 2.2×
Radex Mastoids Compl Minimum 3 Views PR Side (70130) $412 $515 3.9×
Radex Nasal Bones Complete Minimum 3 Views (70160) $208.80 $261 2.3×
Radex Ribs Unilateral 2 Views (71100) $308.80 $386 3.5×
Radex shoulder complete minimum 2 views (73030) $239.20 $299 2.7×
Radex Sinuses Paransl < 3 Views (70210) $196 $245 2.2×
Radex Spine 1 View Specify Level (72020) $165.60 $207 1.9×
Radex Sternum Minimum 2 Views (71120)
range across 2 matching MRF lines
$150.40–$276.80 $188–$346 varies
Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) $336.80 $421 3.8×
Radex Toe Minimum 2 Views (73660) $148 $185 1.7×
Radex upper extremity infant minimum 2 views (73092) $193.60 $242 1.8×
Radex Wrist Complete Minimum 3 Views (73110) $239.20 $299 2.7×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $558.40 $698 5.2×
Radiolog exam mandible compl minimum 4 views (70110) $458.40 $573 4.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $324 $405 3.0×
Radiologic exam colon double contrast study (74280) $1,031.20 $1,289 5.8×
Radiologic exam colon single contrast study (74270) $760.80 $951 4.2×
Radiologic Exam Esophagus Double Contrast Study (74221) $437.60 $547 2.4×
Radiologic exam knee complete 4/more views (73564) $260.80 $326 2.4×
Radiologic exam pelvis compl minimum 3 views (72190) $223.20 $279 2.1×
Radiologic Exam Small Int Single Contrast Study (74250) $660 $825 3.7×
Radiologic exam swallow function contrast study (74230) $475.20 $594 2.7×
Radiologic exam upr gi trc double contrast study (74246) $652 $815 3.6×
Radiologic examination femur 1 view (73551) $178.40 $223 2.0×
Radiologic examination femur minimum 2 views (73552) $178.40 $223 2.0×
Radiologic examination knee 1/2 views (73560) $192 $240 2.2×
Radiologic Examination Osseous Survey Limited (77074) $314.40 $393 2.9×
Radiologic examination tibia & fibula 2 views (73590)
range across 2 matching MRF lines
$141.60–$192 $177–$240 varies
Ribs bilateral 3 views (71110) $560.80 $701 5.3×
Scapula (73010) $252.80 $316 2.4×
Screening Digital Breast Tomosynthesis Bi (77063) $62.40 $78 2.7×
Shoulder 1 view (73020) $220 $275 2.5×
Shoulder Arthrography (73040) $636.80 $796 1.8×
Skull less than 4 views (70250) $225.60 $282 2.1×
Sternoclavicular joints (71130) $250.40 $313 2.8×
Temporomandble Jt Arthrography Rs&I (70332) $619.20 $774 2.5×
Thoracic spine 2 views (72070) $165.60 $207 1.6×
Thoracic spine 3 views (72072) $239.20 $299 2.2×
Thoracolumbar 2 views (72080) $223.20 $279 2.5×
Ultrasound Breast Limited (76642) $187.20 $234 2.1×
Ultrasound Elastography Parenchyma (76981) $396 $495 3.7×
Ultrasound Exam Aaa Screen (76706) $160 $200 1.5×
Ultrasound, abdomen limited (76705) $355.20 $444 3.3×
Umbilical-artery Doppler (OB) (76820) $104.80 $131 1.0×
Unlisted us procedure (76999) $136 $170 1.5×
Upper gi w/o kub (74240) $602.40 $753 3.4×
Urethrocystogram voiding (74455) $957.60 $1,197 3.9×
Us breast unilateral complete (76641) $187.20 $234 1.8×
Us chest (76604) $477.60 $597 4.5×
Us complete joint (76881) $292.80 $366 2.7×
Us exam, pelvic, limited (76857)
range across 2 matching MRF lines
$71.20–$74.40 $89–$93 varies
Us head (76506) $187.20 $234 1.8×
Us kidney transplant (76776) $508 $635 4.8×
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) $96 $120 0.9×
Us ob detailed single fetus (76811) $264 $330 1.1×
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines
$120.80–$121.60 $151–$152 varies
Us ob transvaginal (76817)
range across 2 matching MRF lines
$136.80–$138.40 $171–$173 varies
Us pelvic non ob complete (76856) $156 $195 1.5×
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) $173.60 $217 1.6×
Us preg uterus real time f/u trnsabdl per fetus (76816) $161.60 $202 1.5×
Us retroperitoneal complete (76770) $626.40 $783 5.9×
Us retroperitoneal limited (76775) $434.40 $543 4.1×
Us scrotum and contents (76870) $477.60 $597 4.5×
Us spinal canal and contents (76800) $776 $970 7.3×
Us thyroid (76536) $433.60 $542 4.1×
Us transrectal (76872) $645.60 $807 6.0×
Venography extremity unilateral rs&i (75820) $1,379.20 $1,724 0.9×
Vertebral fracture assessment via dxa (77086) $124.80 $156 1.4×
Wrist 2 views (73100)
range across 2 matching MRF lines
$180.80–$190.40 $226–$238 varies
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $242.40 $303 2.7×
X-ray antegrade pyelogram tube (74425) $371.20 $464 1.0×
X-Ray Bend Only L-S Spine (72120) $309.60 $387 2.9×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 2 matching MRF lines
$188.80–$192 $236–$240 varies
X-Ray Exam Breast Specimen (76098) $770.40 $963 1.4×
X-Ray Exam Entire Spi 1 Vw (72081) $178.40 $223 2.0×
X-Ray Exam Entire Spi 2/3 Vw (72082) $294.40 $368 2.8×
X-Ray Exam Entire Spi 4/5 Vw (72083) $558.40 $698 5.2×
X-Ray Exam Hip Uni 1 View (73501) $160.80 $201 1.8×
X-Ray Exam Hip Uni 2-3 Views (73502) $178.40 $223 2.0×
X-Ray Exam Hip Uni 4/> Views (73503) $294.40 $368 2.8×
X-Ray Exam Hips Bi 2 Views (73521) $294.40 $368 2.8×
X-Ray Exam Hips Bi 3-4 Views (73522) $294.40 $368 2.8×
X-Ray Exam Hips Bi 5/> Views (73523) $558.40 $698 5.2×
X-Ray Exam L-S Spine Bending (72114) $492.80 $616 4.6×
X-Ray Exam Neck Spine 2-3 Vw (72040) $241.60 $302 2.7×
X-Ray Exam Neck Spine 6/>Vws (72052) $423.20 $529 4.0×
X-Ray Exam Unilat Ribs/Chest (71101) $357.60 $447 3.3×
X-ray eye for foreign body (70030) $371.20 $464 4.2×
X-ray humerus (73060)
range across 2 matching MRF lines
$141.60–$193.60 $177–$242 varies
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $278.40 $348 3.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $153.60 $192 1.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $260.80 $326 2.4×
X-ray nose-rectum child f.b. (76010) $141.60 $177 1.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $585.60 $732 5.5×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $204.80 $256 1.9×
X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) $204.80 $256 1.9×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $251.20 $314 2.8×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $290.40 $363 3.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $330.40 $413 3.1×
X-Ray Stress View (77071) $124 $155 1.4×
X-ray thoracic spine 4 vw (72074) $304.80 $381 2.9×
X-Ray Tmj Unilat (70328) $137.60 $172 1.5×
X-Ray Urinary Tract Exam With Contrast Material (74420) $621.60 $777 1.7×
X-Rays Bone Length Studies (77073) $541.60 $677 5.1×
X-Rays Bone Survey Complete (77075) $902.40 $1,128 8.4×
Xr c-spine 4 or 5 views (72050) $359.20 $449 3.4×
Xr facial bones less than 3 views (70140) $307.20 $384 3.5×
Xr orbits complete 4 views (70200) $181.60 $227 1.7×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.