▸ Hospital · PA · CCN 390115

Jefferson Health-northeast

KNIGHTS & RED LION ROADS, PHILADELPHIA, PA, 19114

457 bedsAcute Care Hospitals2

Compliance grade

100/100

Procedures tracked

193

of 209 target codes

Payers

with negotiated rates

Rates published

85,516

last crawl 2026-05-24

▸ Compare with other hospitals All PA hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://use2webtechstgpricelist.blob.core.windows.net/pricelist/Complete%20File/231352152%20_jefferson-abington-hospital_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	2	—	—	$131.94	$134.69	$237.05
Psychiatric eval with medical services	CPT	90792	2	—	—	$149.3	$152.41	$265.38
Psychotherapy 30 minutes	CPT	90832	6	$158	$200.31	$28.6	$54.9	$118.59
Psychotherapy 45 minutes	CPT	90834	6	—	—	$42.9	$77.76	$186.34
Psychotherapy 60 minutes	CPT	90837	6	$158	$200.31	$57.2	$109.88	$248.24
Crisis psychotherapy 60 minutes	CPT	90839	2	$158	$200.31	$108.16	$110.42	$247.03
emergency
ED visit level 1	CPT	99281	11	$1,573	$95.16	$16.85	$28.81	$1,529
ED visit level 2	CPT	99282	14	$2,095	$173.28	$33.3	$65.76	$2,391.15
ED visit level 3	CPT	99283	14	$2,435	$308.06	$35	$96.67	$2,391.15
ED visit level 4	CPT	99284	13	$3,088	$470.9	$50	$159.9	$2,391.15
ED visit level 5	CPT	99285	13	$3,754	$672.07	$50	$250.64	$3,709.12
Critical care, first hour	CPT	99291	15	$5,400	$932.2	$151.63	$248.49	$7,623.86
imaging
CT head without contrast	CPT	70450	34	$2,206	$117.98	$32.19	$105.16	$378.53
CT head with contrast	CPT	70460	34	$2,936	$197.94	$42.64	$158.01	$633.7
CT head with and without contrast	CPT	70470	34	$3,395	$206.55	$48.02	$165.76	$633.7
CT neck with contrast	CPT	70491	34	$1,100	$219.26	$52.02	$159.56	$633.7
MRI brain without contrast	CPT	70551	33	$3,930	$269.26	$55.79	$263.41	$1,117.75
MRI brain with contrast	CPT	70552	33	$5,037	$393.71	$67.31	$336.22	$1,271.27
MRI brain with and without contrast	CPT	70553	33	$1,530	$378.43	$70	$338.93	$1,271.27
Chest X-ray single view	CPT	71045	3	$274	$98.21	$8.11	$12.58	$30.87
Chest X-ray 2 views	CPT	71046	3	$349	$98.21	$9.67	$22.18	$47.14
Chest X-ray 3 views	CPT	71047	3	$419.9	$98.21	$12.44	$28.22	$60.24
CT chest without contrast	CPT	71250	34	$900	$158.23	$40.17	$108.03	$418.76
CT chest with contrast	CPT	71260	34	$4,026	$199.05	$43.98	$162.66	$633.7
CT chest with and without contrast	CPT	71270	33	$5,394.4	$197.94	$47.22	$167.43	$634.91
MRI chest without contrast	CPT	71550	34	$1,945	$398.38	$55.26	$278.94	$1,117.75
MRI chest with contrast	CPT	71551	34	$2,139.5	$884.67	$65.18	$579.34	$2,821.33
MRI chest with and without contrast	CPT	71552	33	$2,334	$557.26	$85.92	$389.26	$1,369.71
Lumbosacral spine X-ray	CPT	72100	3	$482	$117.98	$11.03	$33.6	$64.86
CT cervical spine without contrast	CPT	72125	34	$800	$155.88	$37.53	$108.03	$428
CT thoracic spine without contrast	CPT	72128	33	$1,646	$155.49	$37.53	$115.42	$419.49
CT lumbar spine without contrast	CPT	72131	34	$1,671	$155.09	$37.53	$108.36	$418.15
MRI cervical spine without contrast	CPT	72141	33	$1,400	$269.26	$56.06	$243.39	$1,117.75
MRI thoracic spine without contrast	CPT	72146	33	$4,155	$269.26	$56.06	$230.26	$1,117.75
MRI lumbar spine without contrast	CPT	72148	33	$3,194	$269.26	$59.57	$230.26	$1,117.75
MRI lumbar spine with and without contrast	CPT	72149	32	$3,902	$393.71	$67.93	$338.93	$1,271.27
MRI cervical spine with and without contrast	CPT	72156	33	$2,113	$393.71	$70	$339	$1,271.27
MRI lumbar spine with contrast	CPT	72158	34	$4,872	$393.71	$70	$336.46	$1,271.27
CT pelvis without contrast	CPT	72192	34	$3,019	$117.98	$41.03	$101.57	$412.7
CT pelvis with contrast	CPT	72193	34	$3,270	$269.84	$51.93	$170.41	$694.56
Shoulder X-ray	CPT	73030	3	$799	$98.21	$9.26	$24.64	$49.69
Humerus X-ray	CPT	73060	3	$656	$98.21	$8.25	$17.17	$37.88
Hand X-ray 3 views	CPT	73130	3	$664	$98.21	$8.25	$17.17	$37.88
MRI upper extremity joint without contrast	CPT	73221	33	$1,945	$269.26	$51.22	$244.44	$1,117.75
MRI upper extremity joint with and without contrast	CPT	73223	34	$1,945	$458.06	$81.88	$385.15	$1,271.27
Hip X-ray 2 views	CPT	73510	0	$25	—	—	—	—
Knee X-ray 1-2 views	CPT	73560	3	$620	$98.21	$8.84	$24.64	$48.93
Ankle X-ray 3 views	CPT	73610	3	$85	$44.36	$8.84	$27.97	$53.38
MRI lower extremity joint without contrast	CPT	73721	33	$1,945	$269.26	$51.22	$243.39	$1,117.75
MRI lower extremity joint with and without contrast	CPT	73723	33	$4,279	$456.06	$81.88	$385.15	$1,271.27
CT abdomen without contrast	CPT	74150	34	$975	$162.59	$44.78	$106.65	$425.56
CT abdomen with contrast	CPT	74160	33	$1,055	$197.94	$48.02	$165.76	$711.39
CT abdomen with and without contrast	CPT	74170	34	$1,180	$309.6	$52.55	$181.25	$729.14
CT abdomen and pelvis without contrast	CPT	74176	34	$3,484	$269.26	$67.22	$210.73	$860.44
CT abdomen and pelvis with contrast	CPT	74177	34	$4,877	$393.71	$69.26	$314.28	$1,271.27
CT abdomen and pelvis with and without contrast	CPT	74178	34	$4,877	$404.2	$75.93	$335.85	$1,271.27
MRI abdomen without contrast	CPT	74181	34	$1,400	$231.59	$54.99	$259.27	$1,117.75
MRI abdomen with and without contrast	CPT	74183	34	$2,334	$401.7	$83.48	$385.15	$1,271.27
Abdominal ultrasound complete	CPT	76700	3	$1,883	$117.98	$41.55	$85.86	$189.96
Abdominal ultrasound limited	CPT	76705	31	$1,653	$117.98	$22.27	$92.34	$378.53
Retroperitoneal ultrasound complete	CPT	76770	3	$2,616	$127.27	$35.75	$73.17	$162.5
Obstetric ultrasound first trimester	CPT	76801	32	$660	$139.45	$39.06	$94.18	$378.53
Obstetric ultrasound after first trimester	CPT	76805	33	$450	$161.9	$31	$94.18	$378.53
Obstetric ultrasound with fetal anatomy	CPT	76811	33	$825	$269.26	$63.27	$207.82	$860.44
Transvaginal ultrasound	CPT	76830	3	$520	$140.51	$33	$69.44	$152.53
Pelvic ultrasound complete	CPT	76856	3	$579	$126.11	$33	$69.44	$152.53
Scrotal ultrasound	CPT	76870	3	$1,629	$117.98	$33	$65.71	$147.55
Diagnostic mammography unilateral	CPT	77065	13	$550.4	$148.01	$29.64	$101.98	$320.96
Diagnostic mammography bilateral	CPT	77066	13	$688	$132.47	$36.77	$129.14	$421.59
Screening mammography bilateral	CPT	77067	5	$320	$150.79	$32.65	$115.17	$278.76
EKG complete	CPT	93000	10	$70	$18.37	$14.79	$26.13	$235.3
EKG tracing only	CPT	93005	14	$295	$66.57	$7.54	$14.71	$235.3
EKG interpretation only	CPT	93010	8	—	—	$6.72	$9.16	$20.42
Transthoracic echocardiogram complete	CPT	93306	7	$1,948	$616.65	$47.17	$189.5	$2,078.45
Transthoracic echocardiogram	CPT	93307	7	$1,755	$269.26	$49.92	$185.96	$1,176.48
Stress echocardiogram	CPT	93350	9	$1,735	$616.65	$33	$92.72	$1,176.48
inpatient
COPD w MCC	MS-DRG	190	25	—	$10,236	$8,404.57	$10,218	$36,700
COPD w CC	MS-DRG	191	23	—	$7,877.84	$6,495.67	$7,878.22	$15,786
COPD w/o CC/MCC	MS-DRG	192	23	—	$6,087.52	$4,962.91	$5,639.98	$22,318
AMI discharged alive w MCC	MS-DRG	280	24	—	$14,657	$12,154	$14,092	$54,639
AMI discharged alive w CC	MS-DRG	281	24	—	$8,555.67	$6,949.22	$8,478.03	$33,126
AMI discharged alive w/o CC/MCC	MS-DRG	282	26	—	$6,809.89	$5,526.4	$6,757.7	$23,669
Heart failure & shock w MCC	MS-DRG	291	21	—	$11,804	$9,719.62	$11,791	$47,116
Heart failure & shock w CC	MS-DRG	292	25	—	$7,931.29	$6,510.87	$7,458.48	$31,152
Heart failure & shock w/o CC/MCC	MS-DRG	293	24	—	$5,410.58	$4,250.41	$5,107.93	$21,074
Cardiac arrhythmia w MCC	MS-DRG	308	23	—	$11,093	$9,004.23	$11,154	$22,546
Cardiac arrhythmia w CC	MS-DRG	309	26	—	$6,922.11	$5,629.11	$6,463.14	$24,660
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	21	—	$5,411.47	$4,328.53	$5,221.86	$10,601
GI hemorrhage w CC	MS-DRG	378	23	—	$9,104.35	$7,412.88	$8,615.47	$31,437
GI hemorrhage w/o CC/MCC	MS-DRG	379	21	—	$5,984.2	$4,886.95	$5,663.95	$11,805
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	26	—	$7,313.14	$5,925.68	$6,848.8	$23,180
Fractures of femur w/o MCC	MS-DRG	533	25	—	—	$11,312	$14,085	$43,129
Kidney/UTI w MCC	MS-DRG	689	23	—	$10,704	$8,746.71	$10,938	$35,421
Kidney/UTI w/o MCC	MS-DRG	690	24	—	$7,579.46	$6,086.98	$7,434.72	$24,114
Initial hospital care, low complexity	CPT	99221	10	$175	$88.84	$50.77	$96.01	$244.73
Initial hospital care, moderate complexity	CPT	99222	10	$245	$139	$68.27	$144.1	$299.42
Initial hospital care, high complexity	CPT	99223	10	$360	$185.68	$100.66	$187.27	$441.46
Hospital discharge, <30 min	CPT	99238	10	—	—	$41.45	$82.03	$163.15
Hospital discharge, >30 min	CPT	99239	10	—	—	$59.78	$117.05	$223.19
lab
Basic metabolic panel (BMP)	CPT	80048	39	$60	$9.73	$5.08	$9.31	$24.92
General health panel	CPT	80050	12	$864	—	$23.52	$55.52	$114.87
Electrolyte panel	CPT	80051	35	$28	$8.06	$4.21	$7.43	$28.57
Comprehensive metabolic panel	CPT	80053	41	$40	$12.14	$6.34	$11.62	$43.03
Lipid panel	CPT	80061	40	$536	$15.4	$8.7	$14.46	$54.56
Renal function panel	CPT	80069	29	—	—	$5.21	$9.11	$35.37
Hepatic function panel	CPT	80076	40	$32	$9.4	$4.9	$8.74	$33.29
Urinalysis non-automated	CPT	81002	5	$15	$4	$3.93	$5.54	$9.63
Urinalysis automated	CPT	81003	29	$10	$2.59	$2.14	$2.39	$9.17
Glucose quantitative	CPT	82947	39	$54	$4.52	$2.55	$4.24	$16.01
Hemoglobin A1c	CPT	83036	35	$42	$11.17	$5.83	$10.29	$39.57
Thyroid stimulating hormone (TSH)	CPT	84443	37	$423	$19.32	$10.08	$17.89	$68.46
Complete blood count with automated differential	CPT	85025	36	$81	$8.94	$4.66	$8.16	$31.66
Complete blood count without differential	CPT	85027	39	$64	$7.44	$3.88	$6.96	$26.37
Urine culture bacterial	CPT	87086	36	$36	$9.28	$4.84	$8.72	$32.89
Urine culture identification	CPT	87088	36	$25	$9.3	$4.85	$8.85	$26.62
Tissue exam by pathologist level IV	CPT	88305	9	$195	$83.44	$11.07	$44.2	$127.79
maternity
Fetal non-stress test	CPT	59025	15	$561	$228.16	$5.81	$28.88	$1,181
Routine obstetric care including vaginal delivery	CPT	59400	7	$5,600	$2,679.45	$1,740.17	$2,570.14	$4,573.33
Vaginal delivery only	CPT	59409	12	$8,482	$3,653.17	$688.65	$1,770.3	$7,200
Vaginal delivery with postpartum	CPT	59410	9	—	—	$776.71	$1,892.11	$4,087.5
Routine obstetric care with C-section	CPT	59510	7	$6,600	$3,000.99	$1,786	$2,338.77	$4,199.62
C-section delivery only	CPT	59514	12	$3,700	$1,000.13	$264	$1,476	$7,200
C-section with postpartum	CPT	59515	11	$4,480	$1,488.54	$965.1	$2,296.86	$6,768
Cesarean section w CC/MCC	MS-DRG	765	3	—	—	$5,040	$20,377	$34,872
Cesarean section w/o CC/MCC	MS-DRG	766	2	—	—	$20,377	$23,669	$24,978
office
Office visit, new patient, 15-29 min	CPT	99202	12	$327	—	$35.33	$56.55	$200
Office visit, new patient, 30-44 minutes	CPT	99203	12	$438	—	$52.32	$84.13	$238.47
Office visit, new patient, 45-59 min	CPT	99204	12	$532	—	$73.8	$131.87	$360.89
Office visit, new patient, 60-74 min	CPT	99205	14	$335	$282.51	$60	$158.69	$453.36
Office visit, established patient, 5 min	CPT	99211	10	$272	$29.08	$7.19	$31.9	$200
Office visit, established patient, 10-19 min	CPT	99212	12	$327	—	$16	$42.25	$103.37
Office visit, established patient, 20-29 minutes	CPT	99213	12	$327	—	$16	$59.87	$162.86
Office visit, established patient, 30-39 minutes	CPT	99214	13	$418	—	$54.42	$84.34	$238.06
Office visit, established patient, 40-54 min	CPT	99215	12	$570	—	$71.73	$118.67	$271.1
preventive
Upper GI endoscopy diagnostic	CPT	43235	12	$3,942	$1,023.55	$125.49	$263.62	$3,362
Upper GI endoscopy with biopsy	CPT	43239	12	$3,942	$1,023.55	$144.92	$300.39	$4,204
Sigmoidoscopy diagnostic	CPT	45330	10	$1,278	$1,049.48	$55.15	$114.67	$2,704
Sigmoidoscopy with biopsy	CPT	45331	5	$1,278	$1,049.48	$70.04	$1,082	$2,667
Colonoscopy diagnostic	CPT	45378	14	$3,669	$1,049.48	$55.15	$274.96	$3,508.34
Colonoscopy with biopsy	CPT	45380	14	$5,037	$1,350.43	$210.89	$405.14	$3,508.34
Colonoscopy with polyp removal	CPT	45385	14	$4,828	$1,350.43	$264.52	$472.48	$3,508.34
surgery
Total shoulder arthroplasty	CPT	23472	7	$12,960	$2,344.57	$220	$1,772.3	$19,229
PCI w drug-eluting stent w MCC	MS-DRG	246	2	—	—	$41,916	$44,569	$99,774
PCI w drug-eluting stent w/o MCC	MS-DRG	247	2	—	—	$28,582	$42,666	$63,971
Hip hemiarthroplasty	CPT	27125	12	$2,920	$1,245.2	$213.95	$1,507.28	$7,900
Total hip replacement	CPT	27130	9	$7,500	$2,096.12	$220	$1,993.9	$20,334
Total knee replacement	CPT	27447	9	$8,400	$2,092.34	$220	$1,772.3	$20,334
Knee revision arthroplasty single component	CPT	27486	5	—	—	$156.2	$1,416.67	$20,334
Knee revision arthroplasty all components	CPT	27487	5	—	—	$191.4	$1,324.9	$20,334
Shoulder arthroscopy with decompression	CPT	29826	7	—	—	$119.57	$1,083.68	$6,865
Shoulder arthroscopy with rotator cuff repair	CPT	29827	7	—	—	$141.71	$1,605.45	$10,508
Knee arthroscopy with meniscectomy	CPT	29881	14	$495	$84.31	$452.6	$972.87	$8,267
ACL reconstruction	CPT	29888	14	$5,120	$1,602.77	$144.32	$1,017.26	$8,930.32
Major small/large bowel procedures w MCC	MS-DRG	329	24	—	$41,311	$33,497	$42,583	$160,717
Major small/large bowel procedures w CC	MS-DRG	330	25	—	—	$17,379	$21,060	$80,274
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	24	—	$15,359	$12,224	$14,784	$51,345
CABG single arterial graft	CPT	33533	9	—	—	$220	$1,744.73	$8,451
CABG 2 arterial grafts	CPT	33534	10	$6,350	$2,489.29	$220	$1,993.9	$8,451
CABG 3 arterial grafts	CPT	33535	10	—	—	$220	$2,167.44	$8,451
CABG 4+ arterial grafts	CPT	33536	10	$2,305	$404.14	$220	$2,306.61	$8,451
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	26	—	$15,436	$12,277	$15,604	$51,834
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	25	—	$12,534	$9,812.21	$12,599	$38,364
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	24	—	$30,717	$25,812	$29,931	$115,309
Open appendectomy	CPT	44950	14	$570	$99.42	$66.55	$719.56	$7,200
Laparoscopic appendectomy	CPT	44970	12	—	—	$97.71	$691.97	$8,267
Major joint replacement w MCC	MS-DRG	469	23	—	$27,386	$19,623	$27,858	$56,800
Major joint replacement w/o MCC	MS-DRG	470	24	—	$17,550	$13,920	$19,256	$67,278
Laparoscopic cholecystectomy	CPT	47562	12	—	—	$129.66	$954.48	$12,608
Lap cholecystectomy with cholangiography	CPT	47563	14	—	—	$139.47	$983.05	$12,608
Hip & femur procedures except major joint w MCC	MS-DRG	480	22	—	$26,309	$21,555	$25,585	$96,213
Hip & femur procedures except major joint w CC	MS-DRG	481	23	—	$19,025	$15,290	$19,237	$61,817
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	24	—	—	$11,757	$14,980	$51,110
Lap inguinal hernia repair	CPT	49650	13	—	—	$75.11	$680.72	$8,267
Lap incisional hernia repair	CPT	49652	5	$1,170	—	$467.71	$802.29	$1,360.18
Total abdominal hysterectomy	CPT	58150	5	—	—	$113.85	$804.04	$8,930.32
Vaginal hysterectomy	CPT	58260	6	—	—	$100.65	$910.22	$13,309
Lap-assisted vaginal hysterectomy	CPT	58550	14	—	—	$160.45	$1,089.05	$13,309
Lap-assisted vaginal hysterectomy >250g	CPT	58552	15	—	—	$152.46	$1,081.34	$10,508
Lap salpingo-oophorectomy	CPT	58661	13	$2,635	$704.41	$124.31	$915.36	$10,508
OR procedure for obesity w MCC	MS-DRG	619	16	—	$26,087	$20,003	$26,750	$54,069
OR procedure for obesity w CC	MS-DRG	620	16	—	$14,623	$11,833	$15,086	$60,808
OR procedure for obesity w/o CC/MCC	MS-DRG	621	20	—	$13,805	$10,855	$13,914	$49,439
Complex cataract surgery	CPT	66982	6	—	—	$767.16	$6,632.5	$12,608
Cataract surgery with lens implant	CPT	66984	7	—	—	$662.78	$6,497	$12,608
Intravitreal injection	CPT	67028	15	—	—	$87.09	$179.02	$3,362
Vitrectomy mechanical	CPT	67042	7	—	—	$165.87	$3,314.55	$13,309
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	25	—	$18,621	$14,416	$18,492	$47,282
PCI single major coronary artery	CPT	92920	5	$9,052	$6,423.06	$477.17	$5,928	$8,915.8
PCI with drug-eluting stent	CPT	92928	5	$23,566	$13,028	$530.09	$6,968.4	$9,740
PCI bypass graft	CPT	92937	5	$15,923	$13,028	$529.51	$1,277.21	$9,740
Left heart catheterization	CPT	93452	11	$2,400	$1,051.01	$187.03	$803.06	$8,718
Coronary angiography with cath	CPT	93455	13	$19,238	$3,658.59	$220.77	$954.48	$8,915.8
Coronary angiography with bypass cath	CPT	93458	12	$19,238	$3,658.59	$232.93	$954.48	$8,369

Payer mix (top 30)

Payer	Codes covered	Median rate
Aetna	184	$298.66
ibc	158	$6,010.73
UnitedHealthcare	156	$314.28
Medicaid	151	$142.58
jup pa health_wellness	146	$117.93
Medicare	146	$200.85
Blue Cross Blue Shield	136	$486.22
Cigna	128	$801.21
abington pro ibc	114	$137.81
jup geisinger commercial	107	$307.38
jup health partners chip	104	$117.27
upmc commercial	101	$7,200
keystone first	88	$186.5
Medicare Advantage	87	$338.93
geisinger health plan	87	$860.44
devoted health participation	84	$221.26
optum va ccn	84	$308.12
Humana	83	$214.94
st agnes	83	$308.12
Ambetter	82	$305.55
point of comfort refugee resettlement	82	$210.73
jefferson health plan aca qhp exchange	82	$292.71
pa health_wellness chc	82	$193.77
keystone first vip choice	82	$277.58
ibc main line health	82	$324.28
perennial	81	$244.44
ibc employee benefit	81	$263.41
va_champus_tricare	80	$210.73
innovage	80	$308.12
allwell pa health_wellness ma	80	$231.8