How many shoppable procedure prices are published for Providence St Joseph Medical Center?

Providence St Joseph Medical Center in Polson, MT currently has 117 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Providence St Joseph Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Providence St Joseph Medical Center's median negotiated commercial rate is 2.3× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Critical Access Hospital Voluntary non-profit - Private 22 Beds · rural Updated: 2026-04-01

Providence St Joseph Medical Center

6 13Th Ave E, Polson, MT 59860 · 117 Priced Procedures · 74% Patient Recommendation

CMS Overall Rating No CMS Rating

High Markup · Shop Alternatives

2.33×vs. Fair Market Price

Typical commercial prices here are +133% above the fair benchmark (2.33×) even after accounting for local nurse/doctor wages and patient complexity.

68/100 · Caution

68/100Self-Pay Cash Beats Insurance 12% of the Time

File Completeness61

Price Logic59

Peer Alignment66

Clean Billing68

Real Cash Discount95

High-Markup · Check Safety

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintUpper-Quartile Spread · +21% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Providence St Joseph Medical Center prices routine shoppable procedures at 3.1× Medicare (median 2.19× Fair BaseRate) while upper-quartile commercial rates jump +21% to 2.64× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#24 of 26 in MT · 88th State Percentile#3,210 of 3,385 in U.S. · 94th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 2.07× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 12% of shoppable procedures (95/100 Cash Honesty)
CMS clinical safety score (71/100 safety score) with 74% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (27.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Commercial insurance median sits at 2.19× Fair BaseRate (3.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.64×) jump +21% above the median procedure ratio (Q50 2.19×)
Unnegotiated chargemaster list prices average 6.6× Medicare (18¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

3.1× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.68× Divergence

2.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+21% Upper Tail

Q25 2.07× · Q50 2.19× · Q75 2.64×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

3.1× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.0× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

4.5× MedicareWatchout

Inpatient Lab & PathologyBack-Door Captive

6.4× MedicareWatchout

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.3× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

12% Cash Edge · 95/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 71/100Fair

Procedure Prices at Providence St Joseph Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Bunion correction surgery CPT Code: `28296`	—	$9,713	$3,446	unverified
Cataract surgery with lens implant CPT Code: `66984`	—	$7,046	$2,540	unverified
C-section delivery (full package) CPT Code: `59510`	$3,297	$3,297	$2,975	1.1×
Vaginal delivery (full package) CPT Code: `59400`	$2,909	$2,909	$2,680	1.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,102	$855	2.5×
Total hip replacement CPT Code: `27130`	$1,886	$1,886	$13,413	unverified
Total knee replacement CPT Code: `27447`	$1,884	$1,884	$13,523	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$1,275	$1,275	$1,021	1.2×
Psychological testing by technician CPT Code: `96138`	—	$1,232	$395	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,883	$1,202	$448	2.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,817	$1,202	$511	2.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$960	$960	$3,372	unverified
Gallbladder removal (laparoscopic) CPT Code: `47562`	$981	$981	$6,109	unverified
Trauma team activation HCPCS Code: `G0390`	$962	$962	$1,453	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$932	$762	$272	2.8×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,518	$762	$303	2.5×
MRI, lower back (no contrast) CPT Code: `72148`	$1,957	$762	$338	2.3×
MRI, brain (no contrast) CPT Code: `70551`	$1,764	$762	$343	2.2×
MRI, knee or other leg joint CPT Code: `73721`	$1,724	$762	$369	2.1×
Inguinal hernia repair CPT Code: `49505`	$777	$777	$3,629	unverified
Rabies immune globulin HCPCS Code: `90375`	$1,258	$711	$322	2.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$726	$726	$583	1.2×
Breast lump removal CPT Code: `19120`	$694	$694	$3,875	unverified
CT scan, head (with contrast) CPT Code: `70460`	$1,058	$588	$242	2.4×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,296	$588	$258	2.3×
Colonoscopy with biopsy CPT Code: `45380`	$476	$476	$1,256	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	$417	$417	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$389	$389	$987	unverified
X-ray, lower back CPT Code: `72110`	$330	$349	$112	3.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$355	$349	$126	2.8×
Ultrasound, pelvis CPT Code: `76856`	$359	$349	$130	2.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$434	$349	$132	2.6×
Ultrasound, abdomen (complete) CPT Code: `76700`	$431	$349	$134	2.6×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$349	$151	2.3×
CT scan, head (no contrast) CPT Code: `70450`	$830	$349	$160	2.2×
CT scan, pelvis CPT Code: `72192`	$1,333	$349	$163	2.1×
CT scan, sinuses CPT Code: `70486`	$799	$349	$166	2.1×
CT scan, chest (no contrast) CPT Code: `71250`	$1,380	$349	$167	2.1×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,314	$349	$168	2.1×
CT scan, neck (cervical spine) CPT Code: `72125`	$749	$349	$169	2.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$314	$314	$148	2.1×
Screening mammogram (both breasts) CPT Code: `77067`	$283	$283	$123	2.3×
Blood transfusion CPT Code: `36430`	$295	$295	$498	unverified
X-ray, chest (two views) CPT Code: `71046`	$231	$283	$93	unverified
X-ray, neck (cervical spine) CPT Code: `72040`	$242	$283	$93	unverified
X-ray, shoulder CPT Code: `73030`	$239	$283	$92	unverified
X-ray, hand CPT Code: `73130`	$226	$283	$93	unverified
X-ray, ankle CPT Code: `73610`	$238	$283	$93	unverified
X-ray, foot CPT Code: `73630`	$236	$283	$92	unverified
Psychiatric evaluation (first visit) CPT Code: `90791`	$239	$239	$185	unverified
Office visit, established patient (30-39 min) CPT Code: `99214`	$186	$186	$123	1.5×
X-ray, chest (single view) CPT Code: `71045`	$183	$183	$92	unverified
X-ray, pelvis CPT Code: `72170`	$198	$198	$110	unverified
Psychotherapy session (60 minutes) CPT Code: `90837`	$204	$204	$181	unverified
X-ray, hip CPT Code: `73502`	$178	$178	$93	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$132	$132	$87	1.5×
New patient office visit (30-44 min) CPT Code: `99203`	$142	$142	$110	1.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$139	$139	$166	unverified
Family therapy session CPT Code: `90847`	$146	$146	$173	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$118	$118	$86	1.4×
Neurobehavioral status check CPT Code: `96116`	$137	$137	$231	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$80	$80	$14	5.7×
Psychological testing evaluation CPT Code: `96136`	$93	$93	$128	0.7×
Typhoid vaccine HCPCS Code: `90675`	$1,610	$1,610	$347	4.6×
Drug screening test HCPCS Code: `G0480`	$121	$121	$116	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$146	$146	$203	0.7×
Flu vaccine injection HCPCS Code: `G0008`	—	$138	$48	unverified
Blood test, lipase CPT Code: `83690`	$74	$74	$7	10.6×
Blood test, amylase CPT Code: `82150`	$73	$73	$7	10.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$93	$93	$14	6.6×
Blood test, vitamin B12 CPT Code: `82607`	$80	$80	$16	5.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$89	$89	$39	2.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$204	$106	$56	1.9×
Orthotic fitting and training CPT Code: `97760`	$78	$78	$51	1.5×
Pneumococcal vaccine HCPCS Code: `90732`	$101	$101	$140	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$68	$68	$35	1.9×
Physical therapy (manual therapy) CPT Code: `97140`	$66	$66	$34	1.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$62	$62	$35	1.8×
Occupational therapy (self-care training) CPT Code: `97535`	$67	$67	$38	1.8×
Physical therapy (gait training) CPT Code: `97116`	$58	$58	$33	1.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$55	$55	$38	1.4×
Extended office visit (prolonged) HCPCS Code: `G2212`	$47	$47	$33	1.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$49	$49	$40	1.2×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$68	$68	$64	1.1×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$74	$74	$111	0.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$41	$41	$10	4.1×
Hospital observation (per hour) HCPCS Code: `G0378`	$46	$46	$86	0.5×
Blood test, magnesium CPT Code: `83735`	$60	$15	$7	2.1×
Culture, bacterial CPT Code: `87070`	$82	$19	$9	2.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$151	$40	$19	2.1×
Blood test, vitamin D CPT Code: `82306`	$69	$64	$31	2.1×
Blood test, clotting time (PTT) CPT Code: `85730`	$41	$13	$6	2.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$105	$36	$18	2.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$46	$46	$38	1.2×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$55	$7	$3	2.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$35	$9	$4	2.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$44	$9	$4	2.3×
Blood test, calcium CPT Code: `82310`	$44	$11	$5	2.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$41	$11	$5	2.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$64	$17	$8	2.1×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$114	$23	$11	2.1×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$90	$29	$14	2.1×
Hepatitis C antibody test CPT Code: `86803`	$123	$31	$15	2.1×
Blood test, basic metabolic panel CPT Code: `80048`	$86	$18	$9	2.0×
Blood test, liver function panel CPT Code: `80076`	$77	$18	$9	2.0×
Group therapy session CPT Code: `90853`	$37	$37	$100	0.4×
Blood test, potassium CPT Code: `84132`	$35	$10	$5	2.0×
Blood test, sodium CPT Code: `84295`	$35	$10	$5	2.0×
Culture, blood CPT Code: `87040`	$141	$22	$11	2.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$46	$9	$5	1.8×
Blood test, hemoglobin CPT Code: `85018`	$28	$5	$3	1.7×
Community mental health services HCPCS Code: `H0038`	$22	$22	$16	1.4×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$22	$22	$25	0.9×
Blood antibody screen CPT Code: `86850`	$144	$30	$46	0.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$14	$14	$25	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$16	$16	$37	0.4×
Breathing treatment (nebulizer) CPT Code: `94640`	$17	$17	$201	unverified

Showing top 25 high-impact procedures of 117 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 27.6%

Audit a Bill or Quote at Providence St Joseph Medical Center (Zero PHI Required)

CMS CCN: 271343

CPT 28296

Select Procedure to Audit:

Fair BaseRate™ $3,446

Medicare Rate $3,343

Self-Pay Cash Request Quote

Insurer Median $9,713

1. Amount on Your Bill or Quote ($) Pre-filled with Providence St Joseph Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $6,427 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $6,427

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (27.6% of gross = $6,427).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Providence St Joseph Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$19,865 Above Fair BaseRate

Negotiate Toward $3,446 Fair BaseRate ($3,343 Medicare)

Your bill ($23,311) is $19,865 above the denoised Fair BaseRate ($3,446) and 7.0× the $3,343 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (27.6% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

Safety Composite71/100

Would Recommend74%

Rated 9 or 10 (HCAHPS)80%

Median ER Wait110 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Providence St Joseph Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-10·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (85 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Providence St Joseph Medical Center.

Price Index: 0.65× regional baseline

Quality: 57/100 CMS composite

Median Household Income$61,965U.S. Census ACS

Local Uninsured Share14.1%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 68/100 · Caution CMS CCN 271343

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 271343) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-04-01

Validated Rate Rows84 (CMS v3.0.0)

File Integrity DigestVerified · CCN 271343

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy