Roxborough Memorial Hospital

5800 Ridge Ave, Philadelphia, PA 19128 · Acute care hospital · Emergency room

These are Roxborough Memorial Hospital's own posted figures from its standard-charges file dated September 1, 2026. They are not a quote. Source: the hospital's file · its price transparency page.

201 of the services we track have a posted price here; 187 of them have a discounted cash price. Tap a service to compare it with nearby hospitals. How to read these numbers.

Emergency room

Service	Cash price	Gross charge	Insurer rates (min – max)
Critical care, first 30 to 74 minutes CPT 99291	$844.00	$7,020.00	$334.00 – $6,809.40
Emergency room visit, level 1 (minor) CPT 99281	$86.00	$630.00	$52.55 – $630.00
Emergency room visit, level 2 CPT 99282	$156.00	$988.75	$32.98 – $959.09
Emergency room visit, level 3 (moderate) CPT 99283	$279.00	$1,352.16	$56.65 – $1,311.60
Emergency room visit, level 4 CPT 99284	$426.00	$2,098.99	$95.33 – $2,036.02
Emergency room visit, level 5 (most severe) CPT 99285	$608.00	$3,043.97	$138.74 – $2,952.65
Simple wound repair (stitches), 2.5 cm or less CPT 12001	$205.00	$948.77	$164.09 – $948.77

Office visits

Service	Cash price	Gross charge	Insurer rates (min – max)
New patient office visit, about 15 to 29 minutes CPT 99202	not posted	$626.45	$40.00 – $607.66
New patient office visit, about 30 minutes CPT 99203	not posted	$689.00	$54.25 – $668.33
New patient office visit, about 45 minutes CPT 99204	not posted	$912.94	$90.37 – $885.55
New patient office visit, about 60 minutes CPT 99205	not posted	$1,249.13	$117.54 – $1,211.66
Office visit, established patient, about 10 to 19 minutes CPT 99212	not posted	$626.45	$40.00 – $607.66
Office visit, established patient, about 20 to 29 minutes CPT 99213	not posted	$626.45	$40.00 – $607.66
Office visit, established patient, about 30 to 39 minutes CPT 99214	not posted	$689.00	$54.42 – $668.33
Office visit, established patient, about 40 to 54 minutes CPT 99215	not posted	$912.94	$78.05 – $885.55
Office visit, established patient, brief (often a nurse) CPT 99211	not posted	$403.38	$40.00 – $391.28

Imaging

Service	Cash price	Gross charge	Insurer rates (min – max)
3D screening mammogram (tomosynthesis), add-on CPT 77063	$24.00	$493.20	$19.47 – $478.40
Abdominal X-ray, 1 view CPT 74018	$88.00	$430.61	$13.77 – $417.69
Ankle X-ray, 3 or more views CPT 73610	$88.00	$499.35	$18.73 – $484.37
Bone density scan (DEXA), hips and spine CPT 77080	$106.00	$897.44	$51.94 – $870.52
Breast ultrasound, one breast, complete CPT 76641	$106.00	$725.44	$53.43 – $703.68
Breast ultrasound, one breast, limited CPT 76642	$88.00	$430.61	$40.94 – $417.69
Chest X-ray, 1 view CPT 71045	$88.00	$430.61	$8.11 – $417.69
Chest X-ray, 2 views CPT 71046	$88.00	$501.25	$14.85 – $486.21
CT angiogram of the chest (checks for lung clots) CPT 71275	$179.00	$4,846.81	$143.45 – $4,701.41
CT angiogram of the head CPT 70496	$179.00	$3,616.88	$143.45 – $3,508.37
CT scan of the abdomen and pelvis, with contrast CPT 74177	$356.00	$5,817.50	$192.73 – $5,642.98
CT scan of the abdomen and pelvis, without and with contrast CPT 74178	$356.00	$6,828.58	$254.70 – $6,623.72
CT scan of the abdomen and pelvis, without contrast CPT 74176	$243.00	$1,167.60	$101.07 – $1,132.57
CT scan of the abdomen, without contrast CPT 74150	$106.00	$2,844.31	$77.50 – $2,758.98
CT scan of the chest, with contrast CPT 71260	$179.00	$3,209.70	$87.50 – $3,113.41
CT scan of the chest, without contrast CPT 71250	$106.00	$3,209.70	$83.10 – $3,113.41
CT scan of the head, without contrast CPT 70450	$106.00	$1,654.19	$77.50 – $1,604.56
CT scan of the neck (cervical spine), without contrast CPT 72125	$106.00	$3,041.25	$83.10 – $2,950.01
CT scan of the pelvis, with contrast CPT 72193	$179.00	$3,150.08	$86.50 – $3,055.58
CT scan of the sinuses or face, without contrast CPT 70486	$106.00	$2,473.00	$77.50 – $2,398.81
Diagnostic mammogram, both breasts CPT 77066	$115.00	$624.67	$90.83 – $605.93
Diagnostic mammogram, one breast CPT 77065	$89.00	$455.33	$71.01 – $441.67
Foot X-ray, 3 or more views CPT 73630	$88.00	$490.90	$11.50 – $476.17
Hand X-ray, 3 or more views CPT 73130	$88.00	$491.88	$11.50 – $477.12
Knee X-ray, 3 views CPT 73562	$88.00	$890.94	$16.50 – $864.21
Leg or arm vein ultrasound, both sides CPT 93970	$243.00	$3,067.50	$114.20 – $2,975.47
Leg or arm vein ultrasound, one side CPT 93971	$106.00	$2,967.25	$78.60 – $2,878.23
Lower back X-ray, 2 or 3 views CPT 72100	$106.00	$645.19	$22.50 – $625.83
MRI of both breasts, without and with contrast CPT 77049	not posted	$1,822.51	$219.46 – $1,822.51
MRI of the abdomen, without and with contrast CPT 74183	$356.00	$5,258.75	$285.32 – $5,100.99
MRI of the brain, without and with contrast CPT 70553	$356.00	$5,463.41	$269.00 – $5,299.51
MRI of the brain, without contrast CPT 70551	$243.00	$3,808.34	$195.14 – $3,694.09
MRI of the knee or other leg joint, without contrast CPT 73721	$243.00	$3,737.50	$195.14 – $3,625.38
MRI of the lower back (lumbar spine), without contrast CPT 72148	$243.00	$3,950.55	$187.20 – $3,832.03
MRI of the mid back (thoracic spine), without contrast CPT 72146	$243.00	$3,922.50	$187.20 – $3,804.82
MRI of the neck (cervical spine), without contrast CPT 72141	$243.00	$3,949.78	$195.14 – $3,831.29
MRI of the pelvis, without and with contrast CPT 72197	$356.00	$5,157.34	$285.32 – $5,002.62
MRI of the shoulder or other arm joint, without contrast CPT 73221	$243.00	$5,022.69	$195.14 – $4,872.01
Neck X-ray, 2 or 3 views CPT 72040	$88.00	$534.01	$16.50 – $517.99
Pelvic ultrasound, complete (not pregnancy) CPT 76856	$106.00	$1,418.13	$46.50 – $1,375.59
Pregnancy ultrasound, 14 weeks or later, single baby CPT 76805	$106.00	$1,159.44	$46.50 – $1,124.66
Pregnancy ultrasound, under 14 weeks, single baby CPT 76801	$106.00	$946.86	$38.39 – $918.45
Screening mammogram, both breasts CPT 77067	$94.00	$573.88	$75.02 – $556.66
Shoulder X-ray, 2 or more views CPT 73030	$88.00	$588.63	$16.50 – $570.97
Transvaginal pregnancy ultrasound CPT 76817	$106.00	$823.75	$53.03 – $799.04
Transvaginal ultrasound CPT 76830	$106.00	$937.50	$46.50 – $909.38
Ultrasound of the abdomen, complete CPT 76700	$106.00	$1,456.88	$57.50 – $1,413.17
Ultrasound of the neck or thyroid CPT 76536	$106.00	$922.48	$50.98 – $894.81
Wrist X-ray, 3 or more views CPT 73110	$88.00	$490.00	$11.50 – $475.30
X-ray of the lower back, 4 or more views CPT 72110	$106.00	$826.25	$22.50 – $801.46

Lab tests

Service	Cash price	Gross charge	Insurer rates (min – max)
Basic metabolic panel (blood test) CPT 80048	$8.00	$240.39	$6.77 – $233.18
Blood culture CPT 87040	$10.00	$510.00	$8.26 – $494.70
Blood draw (venipuncture) CPT 36415	$9.00	$53.75	$2.68 – $52.14
BNP test (heart failure) CPT 83880	$39.00	$328.81	$31.41 – $318.95
C-reactive protein (CRP) test CPT 86140	$5.00	$218.75	$3.00 – $212.19
Chlamydia test (DNA/NAAT) CPT 87491	$35.00	$242.44	$23.19 – $235.17
Complete blood count (CBC) with differential CPT 85025	$7.00	$311.25	$6.00 – $301.91
Complete blood count (CBC), automated CPT 85027	$6.00	$398.75	$5.18 – $386.79
Comprehensive metabolic panel (blood test) CPT 80053	$10.00	$341.06	$8.45 – $330.83
COVID-19 PCR test CPT 87635	$51.00	$246.29	$35.49 – $238.90
D-dimer test (blood clots) CPT 85379	$10.00	$290.63	$8.14 – $281.91
Drug screen, instrument chemistry CPT 80307	$62.00	$673.75	$49.71 – $653.54
Ferritin (iron stores) test CPT 82728	$13.00	$188.30	$10.90 – $182.65
Free T4 (thyroid) test CPT 84439	$9.00	$443.75	$7.22 – $430.44
Glucose (blood sugar) test CPT 82947	$3.00	$90.50	$3.14 – $87.78
Gonorrhea test (DNA/NAAT) CPT 87591	$35.00	$242.44	$23.19 – $235.17
Hemoglobin A1c test CPT 83036	$9.00	$311.25	$7.00 – $301.91
Hepatitis C antibody test CPT 86803	$14.00	$398.75	$11.42 – $386.79
HIV-1/HIV-2 antigen and antibody test CPT 87389	$24.00	$54.30	$16.29 – $54.30
Iron test CPT 83540	$6.00	$198.75	$5.18 – $192.79
Kidney function panel CPT 80069	$8.00	$262.50	$6.94 – $254.62
Lipase test (pancreas) CPT 83690	$6.00	$277.50	$5.00 – $269.18
Lipid panel, cholesterol and triglycerides CPT 80061	$13.00	$277.88	$10.71 – $269.54
Liver function panel CPT 80076	$8.00	$253.75	$6.54 – $246.14
Magnesium test CPT 83735	$6.00	$256.25	$5.36 – $248.56
Partial thromboplastin time (PTT), clotting test CPT 85730	$6.00	$151.25	$4.81 – $146.71
Pregnancy blood test (hCG), quantitative CPT 84702	$15.00	$687.50	$12.04 – $666.88
Prothrombin time (PT/INR), clotting test CPT 85610	$4.00	$142.50	$3.43 – $138.22
PSA (prostate specific antigen), free CPT 84154	$18.00	$212.63	$14.71 – $206.25
PSA (prostate specific antigen), total CPT 84153	$18.00	$687.50	$14.71 – $666.88
Rapid strep test CPT 87880	$16.00	$149.00	$6.30 – $144.53
Sed rate (ESR) test CPT 85652	$2.00	$105.20	$2.16 – $102.04
TB skin test CPT 86580	$29.00	$888.10	$5.50 – $861.46
Thyroid stimulating hormone (TSH) CPT 84443	$16.00	$527.50	$13.44 – $511.68
Tissue exam by a pathologist (biopsy specimen) CPT 88305	$53.00	$1,321.25	$9.00 – $1,281.61
Troponin test (heart damage) CPT 84484	$12.00	$333.75	$9.87 – $323.74
Urinalysis, automated, with microscope CPT 81001	$3.00	$207.00	$2.54 – $200.79
Urinalysis, automated, without microscope CPT 81003	$2.00	$103.00	$1.80 – $99.91
Urinalysis, manual, with microscope CPT 81000	$4.00	$676.25	$3.22 – $655.96
Urinalysis, manual, without microscope CPT 81002	$3.00	$52.38	$2.78 – $50.81
Urine culture, colony count CPT 87086	$8.00	$300.00	$6.46 – $291.00
Urine pregnancy test CPT 81025	$8.00	$243.75	$4.00 – $236.44
Vitamin B12 test CPT 82607	$15.00	$190.00	$12.06 – $184.30
Vitamin D test CPT 82306	$29.00	$512.38	$23.68 – $497.01

Heart

Service	Cash price	Gross charge	Insurer rates (min – max)
Carotid artery ultrasound, both sides CPT 93880	$243.00	$2,076.63	$119.34 – $2,014.33
ECG tracing only (no interpretation) CPT 93005	$60.00	$386.25	$10.46 – $374.66
Echocardiogram (heart ultrasound), complete with Doppler CPT 93306	$558.00	$2,899.48	$98.14 – $2,812.50
Left heart catheterization CPT 93452	$3,314.00	$17,129.00	$1,582.00 – $16,615.13
Left heart catheterization with coronary angiogram CPT 93458	$3,314.00	$15,952.00	$1,582.00 – $15,473.44
Nuclear stress test (heart perfusion imaging) CPT 78452	$1,323.00	$5,452.71	$278.34 – $5,289.13

Surgery

Service	Cash price	Gross charge	Insurer rates (min – max)
ACL reconstruction, arthroscopic CPT 29888	$7,418.00	$7,886.50	$776.00 – $7,886.50
Appendix removal, laparoscopic CPT 44970	$6,180.00	$7,274.25	$776.00 – $7,274.25
Breast biopsy with ultrasound guidance CPT 19083	$1,688.00	$7,683.50	$776.00 – $7,452.99
Carpal tunnel release CPT 64721	$1,996.00	$6,843.00	$664.00 – $6,637.71
Colonoscopy with biopsy CPT 45380	$1,223.00	$6,843.00	$238.90 – $6,637.71
Colonoscopy with polyp removal (snare) CPT 45385	$1,223.00	$6,843.00	$284.20 – $6,637.71
Colonoscopy, diagnostic CPT 45378	$950.00	$6,853.15	$191.30 – $6,647.56
Cystoscopy (bladder scope) CPT 52000	$712.00	$2,747.20	$454.38 – $2,747.20
Flexible sigmoidoscopy, diagnostic CPT 45330	$950.00	$2,637.09	$56.30 – $2,637.09
Gallbladder removal, laparoscopic CPT 47562	$6,180.00	$27,344.70	$776.00 – $26,524.36
Hysteroscopy with biopsy or polyp removal CPT 58558	$3,309.00	$11,710.50	$776.00 – $11,359.18
Inguinal (groin) hernia repair, laparoscopic CPT 49650	$6,180.00	$10,625.50	$776.99 – $10,625.50
Inguinal (groin) hernia repair, open, age 5 or older CPT 49505	$3,660.00	$6,790.65	$806.00 – $6,790.65
Kidney stone shock-wave lithotripsy CPT 50590	$3,603.00	$17,420.00	$264.50 – $16,897.40
Knee arthroscopy, meniscus trim (meniscectomy) CPT 29881	$3,345.00	$7,863.00	$932.00 – $7,863.00
Lower colon endoscopy with ultrasound CPT 45391	$1,223.00	$2,904.80	$232.40 – $2,904.80
Nasal endoscopy, diagnostic CPT 31231	$204.00	$731.00	$127.12 – $731.00
Prostate biopsy CPT 55700	$2,049.00	$6,362.00	$101.14 – $6,171.14
Rotator cuff repair, arthroscopic CPT 29827	$7,418.00	$4,028.95	$700.63 – $4,028.95
Screening colonoscopy, average risk HCPCS G0121	$950.00	$2,904.80	$505.14 – $2,904.80
Screening colonoscopy, high risk HCPCS G0105	$950.00	$2,904.80	$505.14 – $2,904.80
Septoplasty (nasal septum repair) CPT 30520	$3,389.00	$10,995.30	$823.00 – $10,665.44
Shoulder arthroscopy, bone shaving (decompression) CPT 29826	not posted	$5,317.96	$924.79 – $5,158.42
Sleeve gastrectomy (weight loss surgery), laparoscopic CPT 43775	not posted	$8,118.00	$1,411.72 – $8,118.00
Total hip replacement CPT 27130	$13,125.00	$21,513.00	$1,582.00 – $21,513.00
Total knee replacement CPT 27447	$13,125.00	$13,113.00	$1,582.00 – $13,113.00
Upper endoscopy (EGD) with biopsy CPT 43239	$927.00	$6,843.00	$157.50 – $6,637.71
Upper endoscopy (EGD), diagnostic CPT 43235	$927.00	$6,843.00	$132.70 – $6,637.71

Pregnancy and birth

Service	Cash price	Gross charge	Insurer rates (min – max)
Fetal non-stress test CPT 59025	not posted	$842.44	$4.72 – $842.44

Hospital stays

Service	Cash price	Insurer rates (min – max)
Alcohol or drug use disorder, without rehab, without major complications MS-DRG 897	$8,807.00	$4,445.10 – $15,290.56
C-section, without complications MS-DRG 788	$9,494.00	$6,547.38 – $16,606.91
Chest pain MS-DRG 313	$7,338.00	$5,133.83 – $12,470.77
COPD flare-up, with major complications MS-DRG 190	$10,838.00	$7,384.90 – $19,185.94
COPD flare-up, without complications MS-DRG 192	$6,634.00	$3,939.30 – $19,388.79
Fainting (syncope) MS-DRG 312	$8,706.00	$6,096.14 – $15,096.57
Gastrointestinal bleeding, with complications MS-DRG 378	$9,691.00	$6,837.09 – $16,986.23
Heart failure, with major complications MS-DRG 291	$12,427.00	$5,617.67 – $22,236.08
Heart failure, without complications MS-DRG 293	$5,948.00	$2,932.73 – $12,776.85
Heart valve or other major heart surgery with cardiac catheterization, with major complications MS-DRG 216	$89,149.00	$23,173.18 – $169,443.18
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470	$18,251.00	$7,650.00 – $33,409.55
Irregular heartbeat, without complications MS-DRG 310	$5,949.00	$3,655.82 – $10,084.73
Kidney failure, with complications MS-DRG 683	$8,744.00	$5,675.18 – $15,169.31
Kidney or urinary tract infection, without major complications MS-DRG 690	$8,146.00	$4,673.26 – $14,020.96
Neck (cervical) spinal fusion, without complications MS-DRG 473	$22,876.00	$7,200.00 – $42,284.59
Normal newborn care MS-DRG 795	$2,642.00	$980.17 – $4,095.77
Nutrition, fluid or electrolyte disorder, without major complications MS-DRG 641	$7,863.00	$5,258.10 – $13,478.83
Pneumonia, with complications MS-DRG 194	$8,113.00	$5,916.77 – $18,235.97
Pneumonia, with major complications MS-DRG 193	$12,704.00	$8,653.74 – $34,680.50
Pneumonia, without complications MS-DRG 195	$6,512.00	$4,191.73 – $27,059.97
Psychoses (inpatient psychiatric stay) MS-DRG 885	$13,447.00	$4,842.58 – $29,250.00
Sepsis, with major complications MS-DRG 871	$18,373.00	$13,287.38 – $33,645.11
Sepsis, without major complications MS-DRG 872	$10,076.00	$6,319.82 – $17,724.09
Skin infection (cellulitis), without major complications MS-DRG 603	$8,700.00	$4,958.30 – $15,084.44
Spinal fusion except neck, without major complications MS-DRG 460	not posted	$11,036.05 – $49,100.95
Stomach and digestive disorders (gastroenteritis), without major complications MS-DRG 392	$7,876.00	$5,153.25 – $35,257.46
Stroke, with complications or clot-busting drug MS-DRG 65	$9,958.00	$5,579.14 – $17,498.92
Uterus and ovary surgery for non-cancer conditions, without complications MS-DRG 743	$12,038.00	$6,750.00 – $21,489.57
Vaginal delivery, without complications MS-DRG 807	$6,924.00	$3,258.94 – $11,677.49
Weight loss surgery, without complications MS-DRG 621	$14,455.00	$5,400.00 – $26,126.27

Pain and spine

Service	Cash price	Gross charge	Insurer rates (min – max)
Large joint injection or drainage (knee, shoulder, hip) CPT 20610	$313.00	$1,403.62	$244.09 – $1,403.62
Lower back nerve root injection with imaging guidance CPT 64483	$904.00	$3,194.65	$95.04 – $3,098.81
Lower back spinal injection (epidural), with imaging guidance CPT 62323	$721.00	$6,803.00	$441.00 – $6,598.91

Eye

Service	Cash price	Gross charge	Insurer rates (min – max)
Laser treatment of clouding after cataract surgery (YAG) CPT 66821	$562.00	$2,349.35	$408.55 – $2,349.35

Eye and ear

Service	Cash price	Gross charge	Insurer rates (min – max)
Hearing test, comprehensive CPT 92557	$131.00	$648.75	$29.00 – $629.29

Sleep

Service	Cash price	Gross charge	Insurer rates (min – max)
Home sleep apnea test CPT 95806	$220.00	$635.50	$99.64 – $616.43
Sleep study with CPAP titration CPT 95811	$877.00	$5,728.19	$517.67 – $5,556.34
Sleep study, overnight in a sleep lab CPT 95810	$877.00	$5,728.19	$270.32 – $5,556.34

Lungs

Service	Cash price	Gross charge	Insurer rates (min – max)
Spirometry (breathing test) CPT 94010	$220.00	$846.19	$9.00 – $820.80

Therapy

Service	Cash price	Gross charge	Insurer rates (min – max)
Manual therapy, 15 minutes CPT 97140	$28.00	$295.00	$21.03 – $286.15
Physical therapy evaluation, low complexity CPT 97161	$100.00	$574.75	$63.61 – $557.51
Physical therapy evaluation, moderate complexity CPT 97162	$100.00	$574.75	$63.61 – $557.51
Physical therapy, therapeutic exercise, 15 minutes CPT 97110	$29.00	$270.00	$8.38 – $261.90
Therapeutic activities, 15 minutes CPT 97530	$36.00	$297.50	$13.00 – $288.57

Mental health

Service	Cash price	Gross charge	Insurer rates (min – max)
Family psychotherapy, with the patient, 50 minutes CPT 90847	$181.00	$911.00	$110.62 – $883.67
Family psychotherapy, without the patient, 50 minutes CPT 90846	$181.00	$750.00	$110.62 – $727.50
Group psychotherapy CPT 90853	$103.00	$431.06	$63.31 – $418.13
Psychiatric diagnostic evaluation CPT 90791	$181.00	$782.75	$110.62 – $759.27
Psychotherapy, 30 minutes CPT 90832	$181.00	$588.81	$102.39 – $571.15
Psychotherapy, 45 minutes CPT 90834	$181.00	$782.75	$110.62 – $759.27
Psychotherapy, 60 minutes CPT 90837	$181.00	$630.05	$109.57 – $611.15

Infusions and injections

Service	Cash price	Gross charge	Insurer rates (min – max)
Injection under the skin or into a muscle CPT 96372	$73.00	$333.84	$12.70 – $323.82
IV hydration, each additional hour CPT 96361	$47.00	$831.25	$9.00 – $806.31
IV hydration, first hour CPT 96360	$217.00	$1,015.78	$31.63 – $985.31
IV push injection of a drug, first CPT 96374	$217.00	$1,015.78	$31.02 – $985.31
IV push injection, each additional drug CPT 96375	$47.00	$278.06	$13.01 – $269.72

Cash price: the hospital's posted discounted price for people paying themselves. Gross charge: its list price before any discount. Insurer rates: the lowest and highest rates it says it negotiated with any insurer. When the file lists a service on several rows, this page shows one (the facility row for the usual setting); the service's own page lists every row.

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