Roxborough Memorial Hospital

5800 Ridge Ave, Philadelphia, PA 19128 · (215) 483-9900

Acute Care HospitalsProprietaryCMS rating 2/5Philadelphia, PA-NJ-DE-MD metro Website ↗

Price file

Prices published

File dated 2026-09-01

6,003 price rows for 58 procedures

Published prices

cash · negotiated range · list

Basic metabolic panel (blood test)

CPT 80048 · lowest of 3 lines · metro median $20

cash

$7 to $37

87 negotiated rates

$240

list

CT scan of the abdomen and pelvis, with contrast

CPT 74177 · lowest of 3 lines · metro median $837

$356

cash

$193 to $848

87 negotiated rates

$5,818

list

CT scan of the head, no contrast

CPT 70450 · lowest of 3 lines · metro median $381

$106

cash

$78 to $591

87 negotiated rates

$1,654

list

CT scan of the pelvis, with contrast

CPT 72193 · lowest of 3 lines · metro median $661

$179

cash

$87 to $832

87 negotiated rates

$3,150

list

Cesarean section hospital stay, no complications

MS-DRG 788 · lowest of 3 lines · metro median $10,367

$9,494

cash

$6,547 to $16,607

72 negotiated rates

—

list

Chlamydia test (DNA)

CPT 87491 · lowest of 3 lines · metro median $58

$35

cash

$23 to $152

87 negotiated rates

$242

list

Colonoscopy (diagnostic)

CPT 45378 · lowest of 12 lines · metro median $1,044

$950

cash

$191 to $3,634

360 negotiated rates

$2,905

list

Colonoscopy with biopsy

CPT 45380 · lowest of 6 lines · metro median $1,360

$1,223

cash

$239 to $3,634

180 negotiated rates

$3,003

list

Colonoscopy with polyp removal

CPT 45385 · lowest of 6 lines · metro median $1,380

$1,223

cash

$284 to $3,634

180 negotiated rates

$3,219

list

Complete blood count (CBC) with differential

CPT 85025 · lowest of 3 lines · metro median $23

cash

$6 to $34

87 negotiated rates

$311

list

Comprehensive metabolic panel (blood test)

CPT 80053 · lowest of 3 lines · metro median $29

$10

cash

$8 to $46

87 negotiated rates

$341

list

Diagnostic mammogram (both breasts)

CPT 77066 · lowest of 3 lines · metro median $189

$115

cash

$91 to $238

87 negotiated rates

$625

list

Established patient office visit (about 40 minutes)

CPT 99215

—

cash

$78 to $88

9 negotiated rates

$913

list

Family psychotherapy with the patient

CPT 90847 · lowest of 3 lines · metro median $174

$181

cash

$111 to $429

69 negotiated rates

$911

list

Family psychotherapy without the patient

CPT 90846 · lowest of 3 lines · metro median $125

$181

cash

$111 to $429

69 negotiated rates

$750

list

Gallbladder removal (laparoscopic)

CPT 47562 · lowest of 6 lines · metro median $1,451

$6,180

cash

$776 to $14,617

177 negotiated rates

$11,256

list

Gonorrhea test (DNA)

CPT 87591 · lowest of 3 lines · metro median $60

$35

cash

$23 to $152

87 negotiated rates

$242

list

Group psychotherapy

CPT 90853 · lowest of 3 lines · metro median $99

$103

cash

$63 to $246

69 negotiated rates

$431

list

Hip or knee replacement, no major complications

MS-DRG 470 · lowest of 3 lines · metro median $26,093

$18,251

cash

$15,361 to $33,410

72 negotiated rates

—

list

Hospital stay for digestive disorders, no complications

MS-DRG 392 · lowest of 3 lines · metro median $11,001

$7,876

cash

$5,153 to $35,257

75 negotiated rates

—

list

Hysterectomy for non-cancer reasons, no complications

MS-DRG 743 · lowest of 3 lines · metro median $15,120

$12,038

cash

$9,515 to $21,490

72 negotiated rates

—

list

Inguinal hernia repair (age 5 and up)

CPT 49505 · lowest of 3 lines · metro median $3,522

$3,660

cash

$806 to $6,791

87 negotiated rates

$6,791

list

Knee arthroscopy with meniscus repair

CPT 29881 · lowest of 3 lines · metro median $3,218

$3,345

cash

$932 to $7,863

90 negotiated rates

$7,863

list

Laser treatment after cataract surgery (YAG)

CPT 66821 · lowest of 3 lines · metro median $404

$562

cash

$450 to $2,349

87 negotiated rates

$2,349

list

Left heart catheterization

CPT 93452 · lowest of 3 lines · metro median $3,830

$3,314

cash

$1,582 to $7,838

87 negotiated rates

$17,129

list

Lipid panel (cholesterol test)

CPT 80061 · lowest of 3 lines · metro median $31

$13

cash

$11 to $59

87 negotiated rates

$278

list

Liver function panel

CPT 80076 · lowest of 3 lines · metro median $24

cash

$7 to $35

87 negotiated rates

$254

list

MRI of the brain, with and without contrast

CPT 70553 · lowest of 3 lines · metro median $1,237

$356

cash

$269 to $2,061

87 negotiated rates

$5,463

list

MRI of the knee or other lower joint, no contrast

CPT 73721 · lowest of 3 lines · metro median $1,011

$243

cash

$195 to $1,271

87 negotiated rates

$3,738

list

MRI of the lower back (lumbar spine), no contrast

CPT 72148 · lowest of 3 lines · metro median $860

$243

cash

$187 to $1,271

87 negotiated rates

$3,951

list

MRI of the neck (cervical spine), no contrast

CPT 72141 · lowest of 3 lines · metro median $877

$243

cash

$195 to $1,271

87 negotiated rates

$3,950

list

Neck (cervical) spinal fusion, no complications

MS-DRG 473 · lowest of 3 lines · metro median $24,166

$22,876

cash

$8,532 to $42,285

90 negotiated rates

—

list

Nerve block injection, lower back, with imaging guidance

CPT 64483 · lowest of 3 lines · metro median $1,020

$904

cash

$95 to $2,139

87 negotiated rates

$3,195

list

New patient office visit (about 30 minutes)

CPT 99203

—

cash

$54 to $61

9 negotiated rates

$689

list

New patient office visit (about 45 minutes)

CPT 99204

—

cash

$90 to $102

9 negotiated rates

$913

list

New patient office visit (about 60 minutes)

CPT 99205

—

cash

$118 to $133

9 negotiated rates

$1,249

list

PSA test (prostate)

CPT 84153 · lowest of 3 lines · metro median $57

$18

cash

$15 to $82

87 negotiated rates

$688

list

Partial thromboplastin time (blood clotting test)

CPT 85730 · lowest of 3 lines · metro median $34

cash

$5 to $29

87 negotiated rates

$151

list

Physical therapy, therapeutic exercise (15 minutes)

CPT 97110 · lowest of 3 lines · metro median $42

$29

cash

$8 to $180

87 negotiated rates

$270

list

Pregnancy ultrasound (after first trimester)

CPT 76805 · lowest of 3 lines · metro median $299

$106

cash

$47 to $268

87 negotiated rates

$1,159

list

Prostate biopsy

CPT 55700 · lowest of 3 lines · metro median $325

$2,049

cash

$101 to $4,848

78 negotiated rates

$6,362

list

Prothrombin time (blood clotting test)

CPT 85610 · lowest of 3 lines · metro median $21

cash

$3 to $18

87 negotiated rates

$143

list

Psychotherapy, 30 minutes

CPT 90832 · lowest of 3 lines · metro median $181

$181

cash

$111 to $429

69 negotiated rates

$589

list

Psychotherapy, 45 minutes

CPT 90834 · lowest of 3 lines · metro median $181

$181

cash

$111 to $429

69 negotiated rates

$783

list

Psychotherapy, 60 minutes

CPT 90837 · lowest of 3 lines · metro median $188

$181

cash

$111 to $429

69 negotiated rates

$630

list

Screening mammogram (both breasts)

CPT 77067 · lowest of 3 lines · metro median $169

$94

cash

$75 to $197

87 negotiated rates

$574

list

Shoulder arthroscopy with decompression

CPT 29826

—

cash

$1,582 to $4,817

21 negotiated rates

$5,318

list

Sleep study (overnight, attended)

CPT 95810 · lowest of 3 lines · metro median $1,062

$877

cash

$270 to $2,076

87 negotiated rates

$5,728

list

Spinal fusion (not neck), no complications

MS-DRG 460

—

cash

$11,036 to $49,101

9 negotiated rates

—

list

Spinal injection, lower back, with imaging guidance

CPT 62323 · lowest of 6 lines · metro median $725

$721

cash

$577 to $3,634

177 negotiated rates

$2,536

list

TSH test (thyroid)

CPT 84443 · lowest of 3 lines · metro median $37

$16

cash

$13 to $82

87 negotiated rates

$528

list

Transvaginal ultrasound

CPT 76830 · lowest of 3 lines · metro median $255

$106

cash

$47 to $253

87 negotiated rates

$938

list

Ultrasound of the abdomen (complete)

CPT 76700 · lowest of 3 lines · metro median $461

$106

cash

$58 to $305

87 negotiated rates

$1,457

list

Upper endoscopy (EGD)

CPT 43235 · lowest of 6 lines · metro median $1,046

$927

cash

$133 to $3,634

180 negotiated rates

$4,430

list

Upper endoscopy with biopsy

CPT 43239 · lowest of 6 lines · metro median $1,069

$927

cash

$158 to $3,634

180 negotiated rates

$4,296

list

Urinalysis with microscope

CPT 81001 · lowest of 3 lines · metro median $13

cash

$3 to $14

87 negotiated rates

$207

list

Vaginal delivery hospital stay, no complications

MS-DRG 807 · lowest of 3 lines · metro median $7,370

$6,924

cash

$3,259 to $11,677

72 negotiated rates

—

list

X-ray of the lower spine (4 or more views)

CPT 72110 · lowest of 3 lines · metro median $236

$106

cash

$23 to $253

87 negotiated rates

$826

list

Source files

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

https://suburbanbhc.org/wp-content/uploads/2026/09/910401_RoxboroughMemorialHospital_standardcharges.json
Suburban Behavioral Health Campus of Roxborough Memorial Hospital · parsed · json v3.0 · file dated 2026-09-01 · 28.7 MB · 2001 price rows read · read Nov 2026
https://roxboroughmemorial.com/wp-content/uploads/2026/09/910401_RoxboroughMemorialHospital_standardcharges.json
Roxborough Memorial Hospital · parsed · json v3.0 · file dated 2026-09-01 · 28.7 MB · 2001 price rows read · read Nov 2026
https://suburbanbhc.org/wp-content/uploads/2026/09/910401_RoxboroughMemorialHospital_standardcharges.json
Suburban Behavioral Health Campus of Roxborough Memorial Hospital · parsed · json v3.0 · file dated 2026-09-01 · 28.7 MB · 2001 price rows read · read Nov 2026