▸ Hospital · PA · CCN 390111

Hospital Of Univ Of Pennsylvania

3400 SPRUCE STREET, PHILADELPHIA, PA, 19104-

1,002 bedsAcute Care Hospitals2

Compliance grade

86/100

Rates published

1,892

last crawl 2026-05-24

Procedures tracked

158

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All PA hospitals JSON

Source MRF: https://www1.pennmedicine.org/images/pricing/231352685_the-trustees-of-the-university-of-pennsylvania-dba-the-hospital-of-the-univer_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	0	—	—	—	—	—
Psychiatric diagnostic evaluation	CPT	90791	0	$783	$783	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$2,400	$2,400	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$552	$552	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$161	$161	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$189	$189	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$126	$126	—	—	—
emergency
ED visit level 1	CPT	99281	0	$1,314	$1,314	—	—	—
ED visit level 2	CPT	99282	0	$1,473	$1,473	—	—	—
ED visit level 3	CPT	99283	0	$2,232	$2,232	—	—	—
ED visit level 4	CPT	99284	0	$3,489	$3,489	—	—	—
ED visit level 5	CPT	99285	0	$6,331	$6,331	—	—	—
Critical care, first hour	CPT	99291	0	$10,688	$10,688	—	—	—
imaging
CT head without contrast	CPT	70450	0	$3,957	$3,957	—	—	—
CT head with contrast	CPT	70460	0	$4,855	$4,855	—	—	—
CT head with and without contrast	CPT	70470	0	$6,026	$6,026	—	—	—
CT neck with contrast	CPT	70491	0	$5,123	$5,123	—	—	—
MRI brain without contrast	CPT	70551	0	$9,957	$9,957	—	—	—
MRI brain with contrast	CPT	70552	0	$11,605	$11,605	—	—	—
MRI brain with and without contrast	CPT	70553	0	$19,502	$19,502	—	—	—
Chest X-ray single view	CPT	71045	0	$471	$471	—	—	—
Chest X-ray 2 views	CPT	71046	0	$797	$797	—	—	—
Chest X-ray 3 views	CPT	71047	0	$615	$615	—	—	—
CT chest without contrast	CPT	71250	0	$4,995	$4,995	—	—	—
CT chest with contrast	CPT	71260	0	$6,041	$6,041	—	—	—
CT chest with and without contrast	CPT	71270	0	$7,583	$7,583	—	—	—
MRI chest without contrast	CPT	71550	0	$10,192	$10,192	—	—	—
MRI chest with contrast	CPT	71551	0	$11,872	$11,872	—	—	—
MRI chest with and without contrast	CPT	71552	0	$19,727	$19,727	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$588	$588	—	—	—
CT cervical spine without contrast	CPT	72125	0	$4,995	$4,995	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$4,995	$4,995	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$4,995	$4,995	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$9,578	$9,578	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$10,369	$10,369	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$10,369	$10,369	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$11,605	$11,605	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$19,434	$19,434	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$19,434	$19,434	—	—	—
CT pelvis without contrast	CPT	72192	0	$4,918	$4,918	—	—	—
CT pelvis with contrast	CPT	72193	0	$5,816	$5,816	—	—	—
Shoulder X-ray	CPT	73030	0	$480	$480	—	—	—
Humerus X-ray	CPT	73060	0	$480	$480	—	—	—
Hand X-ray 3 views	CPT	73130	0	$454	$454	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$9,618	$9,618	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$18,967	$18,967	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$435	$435	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$467	$467	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$9,744	$9,744	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$18,958	$18,958	—	—	—
CT abdomen without contrast	CPT	74150	0	$4,765	$4,765	—	—	—
CT abdomen with contrast	CPT	74160	0	$6,048	$6,048	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$7,739	$7,739	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,778	$3,778	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$7,194	$7,194	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$9,516	$9,516	—	—	—
MRI abdomen without contrast	CPT	74181	0	$9,437	$9,437	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$19,294	$19,294	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$1,819	$1,819	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$1,684	$1,684	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$1,802	$1,802	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$1,811	$1,811	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$3,033	$3,033	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$3,029	$3,029	—	—	—
Transvaginal ultrasound	CPT	76830	0	$2,543	$2,543	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$2,543	$2,543	—	—	—
Scrotal ultrasound	CPT	76870	0	$2,305	$2,305	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$2,032	$2,032	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$2,448	$2,448	—	—	—
Screening mammography bilateral	CPT	77067	0	$2,388	$2,388	—	—	—
EKG tracing only	CPT	93005	0	$898	$898	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$10,616	$10,616	—	—	—
Stress echocardiogram	CPT	93350	0	$5,739	$5,739	—	—	—
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	0	—	—	—	—	—
COPD w MCC	MS-DRG	190	0	—	—	—	—	—
COPD w CC	MS-DRG	191	0	—	—	—	—	—
COPD w/o CC/MCC	MS-DRG	192	0	—	—	—	—	—
Simple pneumonia & pleurisy w CC	MS-DRG	194	0	—	—	—	—	—
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	0	—	—	—	—	—
AMI discharged alive w MCC	MS-DRG	280	0	—	—	—	—	—
AMI discharged alive w CC	MS-DRG	281	0	—	—	—	—	—
AMI discharged alive w/o CC/MCC	MS-DRG	282	0	—	—	—	—	—
Heart failure & shock w MCC	MS-DRG	291	0	—	—	—	—	—
Heart failure & shock w CC	MS-DRG	292	0	—	—	—	—	—
Heart failure & shock w/o CC/MCC	MS-DRG	293	0	—	—	—	—	—
Cardiac arrhythmia w MCC	MS-DRG	308	0	—	—	—	—	—
Cardiac arrhythmia w CC	MS-DRG	309	0	—	—	—	—	—
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	0	—	—	—	—	—
GI hemorrhage w CC	MS-DRG	378	0	—	—	—	—	—
GI hemorrhage w/o CC/MCC	MS-DRG	379	0	—	—	—	—	—
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	0	—	—	—	—	—
Fractures of femur w/o MCC	MS-DRG	533	0	—	—	—	—	—
Kidney/UTI w MCC	MS-DRG	689	0	—	—	—	—	—
Kidney/UTI w/o MCC	MS-DRG	690	0	—	—	—	—	—
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	0	—	—	—	—	—
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	0	—	—	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$263	$263	—	—	—
General health panel	CPT	80050	0	$1,125	$1,125	—	—	—
Electrolyte panel	CPT	80051	0	$218	$218	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$368	$368	—	—	—
Lipid panel	CPT	80061	0	$480	$480	—	—	—
Renal function panel	CPT	80069	0	$102	$102	—	—	—
Hepatic function panel	CPT	80076	0	$254	$254	—	—	—
Urinalysis non-automated	CPT	81002	0	$179	$179	—	—	—
Urinalysis automated	CPT	81003	0	$125	$125	—	—	—
Glucose quantitative	CPT	82947	0	$404	$404	—	—	—
Hemoglobin A1c	CPT	83036	0	$174	$174	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$594	$594	—	—	—
Complete blood count with automated differential	CPT	85025	0	$273	$273	—	—	—
Complete blood count without differential	CPT	85027	0	$245	$245	—	—	—
Urine culture bacterial	CPT	87086	0	$286	$286	—	—	—
Urine culture identification	CPT	87088	0	$240	$240	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$1,775	$1,775	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$1,585	$1,585	—	—	—
Vaginal delivery only	CPT	59409	0	$17,401	$17,401	—	—	—
Vaginal delivery with postpartum	CPT	59410	0	$13,985	$13,985	—	—	—
C-section delivery only	CPT	59514	0	$17,316	$17,316	—	—	—
C-section with postpartum	CPT	59515	0	$17,316	$17,316	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$767	$767	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$468	$468	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$305	$305	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$366	$366	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$518	$518	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$1,294	$1,294	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$3,897	$3,897	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$4,134	$4,134	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$3,010	$3,010	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$3,315	$3,315	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$4,927	$4,927	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$4,399	$4,399	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$6,195	$6,195	—	—	—
surgery
Major small/large bowel procedures w MCC	MS-DRG	329	0	—	—	—	—	—
Major small/large bowel procedures w CC	MS-DRG	330	0	—	—	—	—	—
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	0	—	—	—	—	—
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	0	—	—	—	—	—
Spinal fusion (non-cervical) w MCC	MS-DRG	459	0	—	—	—	—	—
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	0	—	—	—	—	—
Major joint replacement w MCC	MS-DRG	469	0	—	—	—	—	—
Major joint replacement w/o MCC	MS-DRG	470	0	—	—	—	—	—
Hip & femur procedures except major joint w MCC	MS-DRG	480	0	—	—	—	—	—
Hip & femur procedures except major joint w CC	MS-DRG	481	0	—	—	—	—	—
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	0	—	—	—	—	—
Open umbilical hernia repair	CPT	49560	0	$12,502	$12,502	—	—	—
Umbilical hernia repair age 5+	CPT	49585	0	$9,887	$9,887	—	—	—
OR procedure for obesity w MCC	MS-DRG	619	0	—	—	—	—	—
OR procedure for obesity w CC	MS-DRG	620	0	—	—	—	—	—
OR procedure for obesity w/o CC/MCC	MS-DRG	621	0	—	—	—	—	—
Intravitreal injection	CPT	67028	0	$450	$450	—	—	—
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	0	—	—	—	—	—
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	0	—	—	—	—	—
PCI single major coronary artery	CPT	92920	0	$46,950	$46,950	—	—	—
PCI with drug-eluting stent	CPT	92928	0	$127,709	$127,709	—	—	—
PCI bypass graft	CPT	92937	0	$127,709	$127,709	—	—	—
Left heart catheterization	CPT	93452	0	$48,121	$48,121	—	—	—
Coronary angiography with cath	CPT	93455	0	$55,886	$55,886	—	—	—
Coronary angiography with bypass cath	CPT	93458	0	$57,407	$57,407	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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