Roxborough Memorial Hospital

Acute Care Hospitals

2 out of 5 (CMS)

5800 RIDGE AVE

PHILADELPHIA, PA, 19128

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(215) 483-9900

Emergency Services: Yes

Proprietary

Procedure Prices at Roxborough Memorial Hospital

Hc Complete Cbc & Auto Diff Wbc

CPT 85025

List: $311.25

Hc Collection Venous Blood,Venipuncture

CPT 36415

List: $53.75

Hc Metabolic Panel,Comprehensive

CPT 80053

$10

List: $341.06

EKG Tracing

CPT 93005

$60

List: $386.25

Chest X-Ray (1 view)

CPT 71045

$88

List: $430.61

Chest X-Ray (2 views)

CPT 71046

$88

List: $501.25

Diagnostic Mammogram (unilateral)

CPT 77065

$89

List: $455.33

Screening Mammogram (bilateral)

CPT 77067

$94

List: $573.88

CT Chest

CPT 71250

$106

List: $3,209.7

Thoracic Spine X-Ray

CPT 72072

$106

List: $931.38

Abdominal Ultrasound

CPT 76700

$106

List: $1,456.88

Abdominal Ultrasound — Limited

CPT 76705

$106

List: $1,456.88

Retroperitoneal Ultrasound

CPT 76770

$106

List: $1,091.15

OB Ultrasound

CPT 76805

$106

List: $1,159.44

Diagnostic Mammogram (bilateral)

CPT 77066

$115

List: $624.67

Hc Psychotherapy W/Patient 60 Minutes

CPT 90837

$181

List: $630.05

MRI Brain w/o Contrast

CPT 70551

$243

List: $3,808.34

MRI Joint of Lower Extremity

CPT 73721

$243

List: $3,737.5

Echocardiogram

CPT 93307

$243

List: $3,327.54

MRI Brain w/ Contrast

CPT 70553

$356

List: $5,463.41

CT Abdomen & Pelvis

CPT 74177

$356

List: $5,817.5

Echocardiogram w/ Doppler

CPT 93306

$558

List: $2,899.48

Hc Njx Aa&/Strd Tfrml Epi Lumbar/Sacral 1 Level

CPT 64483

$904

List: $3,194.65

Upper GI Endoscopy w/ Biopsy

CPT 43239

$927

List: $4,295.95

Colonoscopy

CPT 45378

$950

List: $2,904.8

Colonoscopy w/ Biopsy

CPT 45380

$1,223

List: $3,002.69

Knee Arthroscopy

CPT 29881

$3,345

List: $7,863

Inguinal Hernia Repair

CPT 49505

$3,660

List: $6,790.65

Laparoscopic Cholecystectomy

CPT 47562

$6,180

List: $27,344.7

Laparoscopic Hernia Repair

CPT 49650

$6,180

List: $10,625.5

Appendectomy

CPT 44950

$6,618

List: $7,743

Sho arthrs srg rt8tr cuf rpr

CPT 29827

$7,418

List: $4,028.95

Hip Replacement

CPT 27130

$13,125

List: $21,513

Knee Replacement

CPT 27447

$13,125

List: $13,113

Prices sourced from federally mandated hospital price transparency files. Cash prices reflect self-pay discounted rates. Negotiated rates vary by insurance plan. Data may not reflect current pricing — always confirm with the hospital before scheduling.