Does Shriners Hospitals for Children - Philadelphia have an emergency room?

Medicare (CMS) data does not list emergency services at Shriners Hospitals for Children - Philadelphia. The closest hospitals that do: Temple University Hospital (0.2 mi), St Christopher's Hospital for Children (1.2 mi) and Jefferson Einstein Philadelphia Hospital (2.2 mi). In a medical emergency, call 911.

Where is Shriners Hospitals for Children - Philadelphia?

3551 N Broad Street, Philadelphia, PA 19104, in Philadelphia County, Pennsylvania.

What is the phone number of Shriners Hospitals for Children - Philadelphia?

(215) 430-4000, as listed by Medicare (CMS).

What is the Medicare star rating of Shriners Hospitals for Children - Philadelphia?

CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Shriners Hospitals for Children - Philadelphia

Quick answers

Does Shriners Hospitals for Children - Philadelphia have an emergency room?: Medicare (CMS) data does not list emergency services at Shriners Hospitals for Children - Philadelphia. The closest hospitals that do: Temple University Hospital (0.2 mi), St Christopher's Hospital for Children (1.2 mi) and Jefferson Einstein Philadelphia Hospital (2.2 mi). In a medical emergency, call 911.
Where is Shriners Hospitals for Children - Philadelphia?: 3551 N Broad Street, Philadelphia, PA 19104, in Philadelphia County, Pennsylvania.
What is the phone number of Shriners Hospitals for Children - Philadelphia?: (215) 430-4000, as listed by Medicare (CMS).
What is the Medicare star rating of Shriners Hospitals for Children - Philadelphia?: CMS does not show an overall star rating for this hospital. This is common, for example when a hospital reports too few quality measures or is not part of the rating program.

Specialties and care areas^[4][12][15]

Orthopedics
Pediatric Rehabilitation and Therapy
Scoliosis
Spine and Spinal Cord
Sports Medicine
Orthotics and Prosthetics
Spine Surgery
Pediatric Orthotic and Prosthetic Services

Conditions treated^{[4][10][12][15]}

Scoliosis
Spinal cord injury
Fractures
Sports injuries
Cerebral palsy
Arthrogryposis multiplex congenita
Brachial plexus conditions
Cleft lip and palate
Chest wall malformations (pectus excavatum, pectus carinatum)
Limb deficiencies
Neurofibromatosis type I
Kyphosis
Torticollis
Spina bifida

Treatments^[4][10][13]

Vertebral body tethering
Botulinum toxin injections
Bracing
Casting
Limb lengthening
Motion analysis

Procedures^[4][10][12]

Spine surgery
Vertebral body tethering
Orthopedic surgery
X-rays

Programs and centers^{[4][7][9][10][11]}

Young Adult Transition in Care Program
Motion Analysis (MAC Lab)
Telehealth appointments
Spinal cord injury care
Walk-in fracture clinic
Thera-Stride Camp
GLAHM (Good Lives and Healthy Minds) camp
Art class
Music therapy
Patient Ambassador Program
Therapeutic recreation and child life
Pet therapy
School re-entry program
Team Impact
School services for hospitalized students

Visiting and practical information

Visiting	Up to 4 visitors per patient (up to 2 parents/caregivers plus 2 others, siblings count); check in at lobby front desk for sticker^[8]
Parking	Free 24-hour parking for patients and families in a garage next to the hospital, between Tioga and Venango Streets^[6]
Interpreters and languages	Interpreter services are listed as a patient service^[4]
Patient portal	https://www.shrinerschildrens.org/en/patient-information/patient-portal

Recognition^[11]

Accredited by The Joint Commission

Nearest emergency rooms

Hospitals that list emergency services, by straight-line distance (not driving distance).

Temple University Hospital0.2 mi · Philadelphia, PA · Acute Care Hospital
St Christopher's Hospital for Children1.2 mi · Philadelphia, PA · Children's Hospital
Jefferson Einstein Philadelphia Hospital2.2 mi · Philadelphia, PA · Acute Care Hospital
Roxborough Memorial Hospital3.4 mi · Philadelphia, PA · Acute Care Hospital
Thomas Jefferson University Hospital4.0 mi · Philadelphia, PA · Acute Care Hospital

Other hospitals nearby

Haven Behavioral Hospital of Philadelphia1.6 mi · Philadelphia, PA · Psychiatric Hospital
Kensington Hospital2.0 mi · Philadelphia, PA · Acute Care Hospital
Friends Hospital3.1 mi · Philadelphia, PA · Psychiatric Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Aristacare at East Falls1.7 mi · Philadelphia, PA · 1 of 5 stars
Willowcrest2.0 mi · Philadelphia, PA · 5 of 5 stars
Willow Terrace2.1 mi · Philadelphia, PA · 2 of 5 stars

All nursing homes in the state →

Hospice providers

Echo Hospice of Pennsylvania, LLC3.0 mi · Philadelphia, PA
Immediate Homecare and Hospice4.2 mi · Philadelphia, PA
Heartland Hospice (Philadelphia)4.2 mi · Bala Cynwyd, PA

All hospice providers in the state →

Home health agencies

Easy Care Health Care0.5 mi · Philadelphia, PA
Delia Maria Home Care Agency, LLC1.1 mi · Philadelphia, PA
Honest Elite Caregivers, Inc.2.2 mi · Philadelpha, PA

All home health agencies in the state →

Dialysis facilities

DaVita Lehigh Avenue Dialysis1.2 mi · Philadelphia, PA · 3 of 5 stars
FKC Cambria1.2 mi · Philadelphia, PA · 1 of 5 stars
DCI Philadelphia1.8 mi · Philadelphia, PA · 3 of 5 stars

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

Children's Dental Surgery of Philadelphia2.6 mi · Philadelphia, PA
ReVaMP Heart & Vascular Surgery Center3.0 mi · Philadelphia, PA
Metro Vascular Care3.8 mi · Philadelphia, PA

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

GPHA, INC. Medical Suite at Temple's Dental School0.3 mi · Philadelphia, PA · Community health center
Hunting Park Health Center0.7 mi · Philadelphia, PA · Community health center
Maria de los Santos Health Ctr0.9 mi · Philadelphia, PA · Community health center

Clinics and urgent care

Ahpaffs, LLC1.1 mi · Philadelphia, PA · Urgent care center
Ampersand Health - De, LLC1.1 mi · Philadelphia, PA · Urgent care center
American Current Care P.A .2.2 mi · Philadelphia, PA · Urgent care center

Pharmacies

Discount Pharmacy Inc0.5 mi · Philadelphia, PA · Community/retail pharmacy
Esperanza Health Center Inc0.5 mi · Philadelphia, PA · Clinic pharmacy
Greater Philadelphia Health Action Inc.0.5 mi · Philadelphia, PA · Pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Chelten Christian Crusade for All People, Inc0.5 mi · Philadelphia, PA
Christian Life Services0.5 mi · Philadelphia, PA
New Manor Personal Care Boarding Home0.5 mi · Philadelphia, PA
Quality Assisted Care0.5 mi · Philadelphia, PA

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Shriners Hospitals for Children - Philadelphia reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Not reported to Medicare

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	Not reported to Medicare
Catheter-associated urinary tract infections (CAUTI)	Not reported to Medicare
Surgical site infections after colon surgery	Not reported to Medicare
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	Not reported to Medicare
Clostridioides difficile (C. diff) intestinal infections	Not reported to Medicare

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	Not reported to Medicare
Deaths within 30 days: heart failure patients	Not reported to Medicare
Deaths within 30 days: pneumonia patients	Not reported to Medicare
Deaths within 30 days: COPD patients	Not reported to Medicare
Deaths within 30 days: stroke patients	Not reported to Medicare
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	Not reported to Medicare
Complications after hip or knee replacement	Not reported to Medicare

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	Not reported to Medicare
Readmitted within 30 days: heart failure	Not reported to Medicare
Readmitted within 30 days: pneumonia	Not reported to Medicare
Readmitted within 30 days: COPD	Not reported to Medicare
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	Not reported to Medicare

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Average (median) time patients spent in the emergency room before leaving (OP-18b)	Not reported to Medicare
Patients who left the emergency room before being seen (OP-22)	Not reported to Medicare
Sepsis patients who got all the recommended early care (SEP-1)	Not reported to Medicare

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in Philadelphia Best hospitals in Philadelphia

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 39 common services exactly as Shriners Hospitals for Children - Philadelphia lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	$466.62	$466.62	$56.34 – $103.59
New patient office visit (about 30–44 minutes): 10 of 24 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $73.99 AmeriHealth Caritas NC — Marketplace Medicare: $85.09 AmeriHealth Caritas SC — Medicare: $85.09 Centene Ambetter — Centene Ambetter: $85.09 Centene Magnolia Health Services — Mgd. Medicaid: $73.99 Centene Peach State Health — Managed Medicaid: $56.34 Centene Wellcare of KY — Managed Medicaid: $73.99 Sana Benefits — Commercial: $103.59 Soonercare — Managed Medicaid: $71.02 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$329.50	$329.50	$56.34 – $103.59
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $73.99 AmeriHealth Caritas NC — Marketplace Medicare: $85.09 AmeriHealth Caritas SC — Medicare: $85.09 Centene Ambetter — Centene Ambetter: $85.09 Centene Magnolia Health Services — Mgd. Medicaid: $73.99 Centene Peach State Health — Managed Medicaid: $56.34 Centene Wellcare of KY — Managed Medicaid: $73.99 Sana Benefits — Commercial: $103.59 Soonercare — Managed Medicaid: $71.02 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$329.50	$329.50	$73.99 – $103.59
New patient office visit (about 30–44 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $73.99 AmeriHealth Caritas NC — Marketplace Medicare: $85.09 AmeriHealth Caritas SC — Medicare: $85.09 Centene Ambetter — Centene Ambetter: $85.09 Centene Magnolia Health Services — Mgd. Medicaid: $73.99 Centene Wellcare of KY — Managed Medicaid: $73.99 Sana Benefits — Commercial: $103.59 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	$757.13	$757.13	$83.59 – $169.29
New patient office visit (about 45–59 minutes): 10 of 24 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $120.92 AmeriHealth Caritas NC — Marketplace Medicare: $139.06 AmeriHealth Caritas SC — Medicare: $139.06 Centene Ambetter — Centene Ambetter: $139.06 Centene Magnolia Health Services — Mgd. Medicaid: $120.92 Centene Peach State Health — Managed Medicaid: $83.59 Centene Wellcare of KY — Managed Medicaid: $120.92 Sana Benefits — Commercial: $169.29 Soonercare — Managed Medicaid: $115.69 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$418.90	$418.90	$83.59 – $169.29
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $120.92 AmeriHealth Caritas NC — Marketplace Medicare: $139.06 AmeriHealth Caritas SC — Medicare: $139.06 Centene Ambetter — Centene Ambetter: $139.06 Centene Magnolia Health Services — Mgd. Medicaid: $120.92 Centene Peach State Health — Managed Medicaid: $83.59 Centene Wellcare of KY — Managed Medicaid: $120.92 Sana Benefits — Commercial: $169.29 Soonercare — Managed Medicaid: $115.69 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$418.90	$418.90	$120.92 – $169.29
New patient office visit (about 45–59 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $120.92 AmeriHealth Caritas NC — Marketplace Medicare: $139.06 AmeriHealth Caritas SC — Medicare: $139.06 Centene Ambetter — Centene Ambetter: $139.06 Centene Magnolia Health Services — Mgd. Medicaid: $120.92 Centene Wellcare of KY — Managed Medicaid: $120.92 Sana Benefits — Commercial: $169.29 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	$1,029.83	$1,029.83	$12 – $232.46
New patient office visit (about 60–74 minutes): 10 of 24 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $166.04 AmeriHealth Caritas NC — Marketplace Medicare: $190.95 AmeriHealth Caritas SC — Medicare: $190.95 Centene Ambetter — Centene Ambetter: $190.95 Centene Magnolia Health Services — Mgd. Medicaid: $166.04 Centene Peach State Health — Managed Medicaid: $108.92 Centene Wellcare of KY — Managed Medicaid: $166.04 Sana Benefits — Commercial: $232.46 Soonercare — Managed Medicaid: $157.28 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFFICE O/P NEW HI 60 MIN	$620.10	$620.10	$12 – $232.46
New patient office visit (about 60–74 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $166.04 AmeriHealth Caritas NC — Marketplace Medicare: $190.95 AmeriHealth Caritas SC — Medicare: $190.95 Centene Ambetter — Centene Ambetter: $190.95 Centene Magnolia Health Services — Mgd. Medicaid: $166.04 Centene Peach State Health — Managed Medicaid: $108.92 Centene Wellcare of KY — Managed Medicaid: $166.04 Sana Benefits — Commercial: $232.46 Soonercare — Managed Medicaid: $157.28 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$293.10	$293.10	$28.53 – $82.96
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $59.26 AmeriHealth Caritas NC — Marketplace Medicare: $68.15 AmeriHealth Caritas SC — Medicare: $68.15 Centene Ambetter — Centene Ambetter: $68.15 Centene Magnolia Health Services — Mgd. Medicaid: $59.26 Centene Peach State Health — Managed Medicaid: $28.53 Centene Wellcare of KY — Managed Medicaid: $59.26 Sana Benefits — Commercial: $82.96 Soonercare — Managed Medicaid: $57.22 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST LOW 20 MIN	$285.90	$285.90	$2,113 – $3,895
Established patient office visit (about 20–29 minutes): 10 of 11 insurance plan rates Capital District Health Plan — Commercial: $3,895 Centene Arkansas Total Care — Managed Medicaid: $3,137 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Sentara Health Administration — Commercial: 40% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$293.10	$293.10	$59.26 – $82.96
Established patient office visit (about 20–29 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $59.26 AmeriHealth Caritas NC — Marketplace Medicare: $68.15 AmeriHealth Caritas SC — Medicare: $68.15 Centene Ambetter — Centene Ambetter: $68.15 Centene Magnolia Health Services — Mgd. Medicaid: $59.26 Centene Wellcare of KY — Managed Medicaid: $59.26 Sana Benefits — Commercial: $82.96 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$329.50	$329.50	$46.05 – $122.09
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $87.21 AmeriHealth Caritas NC — Marketplace Medicare: $100.29 AmeriHealth Caritas SC — Medicare: $100.29 Centene Ambetter — Centene Ambetter: $100.29 Centene Magnolia Health Services — Mgd. Medicaid: $87.21 Centene Peach State Health — Managed Medicaid: $46.05 Centene Wellcare of KY — Managed Medicaid: $87.21 Sana Benefits — Commercial: $122.09 Soonercare — Managed Medicaid: $84.24 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Inpatient (hospital stay) · Hospital (facility) fee In the file: OFFICE O/P EST MOD 30 MIN	$321.50	$321.50	$2,113 – $3,895
Established patient office visit (about 30–39 minutes): 10 of 11 insurance plan rates Capital District Health Plan — Commercial: $3,895 Centene Arkansas Total Care — Managed Medicaid: $3,137 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Sentara Health Administration — Commercial: 40% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$329.50	$329.50	$87.21 – $122.09
Established patient office visit (about 30–39 minutes): 10 of 22 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $87.21 AmeriHealth Caritas NC — Marketplace Medicare: $100.29 AmeriHealth Caritas SC — Medicare: $100.29 Centene Ambetter — Centene Ambetter: $100.29 Centene Magnolia Health Services — Mgd. Medicaid: $87.21 Centene Wellcare of KY — Managed Medicaid: $87.21 Sana Benefits — Commercial: $122.09 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Office consultation with a specialist (moderate to high) CPT 99244 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OFF/OP CNSLTJ NEW/EST MOD 40	$575.54	$575.54	$141.66
Office consultation with a specialist (moderate to high): 10 of 14 insurance plan rates Centene Peach State Health — Managed Medicaid: $141.66 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount) Capital District Health Plan — Commercial: 60% (a percentage in the contract, not a dollar amount) Centene Carolina Complete Health — Managed Medicai: 22% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Providence Health Plan — Commercial: 72% (a percentage in the contract, not a dollar amount)

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA	$74.80	$74.80	$7.53 – $15.95
Basic metabolic panel (blood test): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $8.46 Aetna Better Health of PA — Managed Medicaid: $9.36 AmeriHealth Caritas NC — Marketplace Medicare: $9.73 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 AmeriHealth Caritas SC — Medicare: $9.73 AmeriHealth Mercy Health Plans — Managed Medicaid: $9.36 Centene Absolute Total Care — Managed Medicaid: $10.91 Centene Ambetter — Centene Ambetter: $9.73 Centene Carolina Complete Health — Managed Medicai: $14.62 Centene Magnolia Health Services — Mgd. Medicaid: $8.46
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$74.80	$74.80	$7.53 – $11.84
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $8.46 Aetna Better Health of PA — Managed Medicaid: $9.36 AmeriHealth Caritas NC — Marketplace Medicare: $9.73 AmeriHealth Caritas SC — Medicare: $9.73 AmeriHealth Mercy Health Plans — Managed Medicaid: $9.36 Centene Ambetter — Centene Ambetter: $9.73 Centene Magnolia Health Services — Mgd. Medicaid: $8.46 Centene PA Health and Wellness — Mgd. Medicaid: $9.36 Centene Wellcare of KY — Managed Medicaid: $8.46 Gateway Health Plan — Managed Medicaid: $9.36
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$93.40	$93.40	$9.39 – $19.90
Comprehensive metabolic panel (blood test): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $10.56 Aetna Better Health of PA — Managed Medicaid: $11.69 AmeriHealth Caritas NC — Marketplace Medicare: $12.14 AmeriHealth Caritas of NC — Managed Medicaid: $15.41 AmeriHealth Caritas SC — Medicare: $12.14 AmeriHealth Mercy Health Plans — Managed Medicaid: $11.69 Centene Absolute Total Care — Managed Medicaid: $12.32 Centene Ambetter — Centene Ambetter: $12.14 Centene Carolina Complete Health — Managed Medicai: $15.41 Centene Magnolia Health Services — Mgd. Medicaid: $10.56
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier QW In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$93.40	$93.40	$9.39 – $14.78
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $10.56 Aetna Better Health of PA — Managed Medicaid: $11.69 AmeriHealth Caritas NC — Marketplace Medicare: $12.14 AmeriHealth Caritas SC — Medicare: $12.14 AmeriHealth Mercy Health Plans — Managed Medicaid: $11.69 Centene Ambetter — Centene Ambetter: $12.14 Centene Magnolia Health Services — Mgd. Medicaid: $10.56 Centene PA Health and Wellness — Mgd. Medicaid: $11.69 Centene Wellcare of KY — Managed Medicaid: $10.56 Gateway Health Plan — Managed Medicaid: $11.69
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$93.40	$93.40	$10.56 – $14.78
Comprehensive metabolic panel (blood test): 10 of 24 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $10.56 AmeriHealth Caritas NC — Marketplace Medicare: $12.14 AmeriHealth Caritas SC — Medicare: $12.14 Centene Ambetter — Centene Ambetter: $12.14 Centene Magnolia Health Services — Mgd. Medicaid: $10.56 Centene Wellcare of KY — Managed Medicaid: $10.56 Sana Benefits — Commercial: $14.78 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIPID PANEL	$118.40	$118.40	$11.91 – $25.90
Cholesterol panel (lipid panel): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $13.39 Aetna Better Health of PA — Managed Medicaid: $14 AmeriHealth Caritas NC — Marketplace Medicare: $15.40 AmeriHealth Caritas of NC — Managed Medicaid: $24.45 AmeriHealth Caritas SC — Medicare: $15.40 AmeriHealth Mercy Health Plans — Managed Medicaid: $14 Centene Absolute Total Care — Managed Medicaid: $12.64 Centene Ambetter — Centene Ambetter: $15.40 Centene Carolina Complete Health — Managed Medicai: $24.45 Centene Magnolia Health Services — Mgd. Medicaid: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: RENAL FUNCTION PANEL	$76.60	$76.60	$7.38 – $16.36
Kidney function panel: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $8.68 Aetna Better Health of PA — Managed Medicaid: $9.60 AmeriHealth Caritas NC — Marketplace Medicare: $9.98 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 AmeriHealth Caritas SC — Medicare: $9.98 AmeriHealth Mercy Health Plans — Managed Medicaid: $9.60 Centene Absolute Total Care — Managed Medicaid: $11.19 Centene Ambetter — Centene Ambetter: $9.98 Centene Carolina Complete Health — Managed Medicai: $14.62 Centene Magnolia Health Services — Mgd. Medicaid: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: HEPATIC FUNCTION PANEL	$72.20	$72.20	$7.27 – $15.40
Liver function panel: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $8.17 Aetna Better Health of PA — Managed Medicaid: $9.03 AmeriHealth Caritas NC — Marketplace Medicare: $9.40 AmeriHealth Caritas of NC — Managed Medicaid: $14.62 AmeriHealth Caritas SC — Medicare: $9.40 AmeriHealth Mercy Health Plans — Managed Medicaid: $9.03 Centene Absolute Total Care — Managed Medicaid: $10.53 Centene Ambetter — Centene Ambetter: $9.40 Centene Carolina Complete Health — Managed Medicai: $14.62 Centene Magnolia Health Services — Mgd. Medicaid: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$28	$28	$2.82 – $6
Urine test (automated, with microscope): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $3.17 Aetna Better Health of PA — Managed Medicaid: $3 AmeriHealth Caritas NC — Marketplace Medicare: $3.65 AmeriHealth Caritas of NC — Managed Medicaid: $5.78 AmeriHealth Caritas SC — Medicare: $3.65 AmeriHealth Mercy Health Plans — Managed Medicaid: $3 Centene Absolute Total Care — Managed Medicaid: $4.07 Centene Ambetter — Centene Ambetter: $3.65 Centene Carolina Complete Health — Managed Medicai: $5.78 Centene Magnolia Health Services — Mgd. Medicaid: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS NONAUTO W/O SCOPE	$22.60	$22.60	$3.05 – $6.82
Urine test (manual, without microscope): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $3.48 Aetna Better Health of PA — Managed Medicaid: $3.57 AmeriHealth Caritas NC — Marketplace Medicare: $4 AmeriHealth Caritas of NC — Managed Medicaid: $4.67 AmeriHealth Caritas SC — Medicare: $4 AmeriHealth Mercy Health Plans — Managed Medicaid: $3.57 Centene Absolute Total Care — Managed Medicaid: $3.29 Centene Ambetter — Centene Ambetter: $4 Centene Carolina Complete Health — Managed Medicai: $4.67 Centene Magnolia Health Services — Mgd. Medicaid: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$19.90	$19.90	$2 – $4.63
Urine test (automated, without microscope): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $2.25 Aetna Better Health of PA — Managed Medicaid: $3.10 AmeriHealth Caritas NC — Marketplace Medicare: $2.59 AmeriHealth Caritas of NC — Managed Medicaid: $4.10 AmeriHealth Caritas SC — Medicare: $2.59 AmeriHealth Mercy Health Plans — Managed Medicaid: $3.10 Centene Absolute Total Care — Managed Medicaid: $2.90 Centene Ambetter — Centene Ambetter: $2.59 Centene Carolina Complete Health — Managed Medicai: $4.10 Centene Magnolia Health Services — Mgd. Medicaid: $2.25
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$148.30	$148.30	$14.94 – $35.71
Thyroid stimulating hormone (TSH) test: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $16.80 Aetna Better Health of PA — Managed Medicaid: $23.21 AmeriHealth Caritas NC — Marketplace Medicare: $19.32 AmeriHealth Caritas of NC — Managed Medicaid: $29.73 AmeriHealth Caritas SC — Medicare: $19.32 AmeriHealth Mercy Health Plans — Managed Medicaid: $23.21 Centene Absolute Total Care — Managed Medicaid: $21.65 Centene Ambetter — Centene Ambetter: $19.32 Centene Carolina Complete Health — Managed Medicai: $29.73 Centene Magnolia Health Services — Mgd. Medicaid: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$68.70	$68.70	$6 – $14.99
Complete blood count (CBC) with differential: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $7.77 Aetna Better Health of PA — Managed Medicaid: $6 AmeriHealth Caritas NC — Marketplace Medicare: $8.94 AmeriHealth Caritas of NC — Managed Medicaid: $14.17 AmeriHealth Caritas SC — Medicare: $8.94 AmeriHealth Mercy Health Plans — Managed Medicaid: $6 Centene Absolute Total Care — Managed Medicaid: $9.56 Centene Ambetter — Centene Ambetter: $8.94 Centene Carolina Complete Health — Managed Medicai: $14.17 Centene Magnolia Health Services — Mgd. Medicaid: $7.77
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$68.70	$68.70	$7.77 – $10.88
Complete blood count (CBC) with differential: 10 of 24 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $7.77 AmeriHealth Caritas NC — Marketplace Medicare: $8.94 AmeriHealth Caritas SC — Medicare: $8.94 Centene Ambetter — Centene Ambetter: $8.94 Centene Magnolia Health Services — Mgd. Medicaid: $7.77 Centene Wellcare of KY — Managed Medicaid: $7.77 Sana Benefits — Commercial: $10.88 Aetna National — Commercial: 75% (a percentage in the contract, not a dollar amount) Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) AmeriHealth Caritas of NC — Managed Medicaid: 22% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$90	$90	$5.75 – $13.63
Complete blood count (CBC), automated: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $6.47 Aetna Better Health of PA — Managed Medicaid: $7.52 AmeriHealth Caritas NC — Marketplace Medicare: $7.44 AmeriHealth Caritas of NC — Managed Medicaid: $11.81 AmeriHealth Caritas SC — Medicare: $7.44 AmeriHealth Mercy Health Plans — Managed Medicaid: $7.52 Centene Absolute Total Care — Managed Medicaid: $7.68 Centene Ambetter — Centene Ambetter: $7.44 Centene Carolina Complete Health — Managed Medicai: $11.81 Centene Magnolia Health Services — Mgd. Medicaid: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$34.60	$34.60	$3.82 – $7.63
Blood clotting time test (prothrombin time, PT): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $4.29 Aetna Better Health of PA — Managed Medicaid: $4 AmeriHealth Caritas NC — Marketplace Medicare: $4.93 AmeriHealth Caritas of NC — Managed Medicaid: $7.17 AmeriHealth Caritas SC — Medicare: $4.93 AmeriHealth Mercy Health Plans — Managed Medicaid: $4 Centene Absolute Total Care — Managed Medicaid: $5.06 Centene Ambetter — Centene Ambetter: $4.93 Centene Carolina Complete Health — Managed Medicai: $7.17 Centene Magnolia Health Services — Mgd. Medicaid: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$53.10	$53.10	$4.50 – $12.81
Blood clotting test (partial thromboplastin time, PTT): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $6.01 Aetna Better Health of PA — Managed Medicaid: $7.50 AmeriHealth Caritas NC — Marketplace Medicare: $6.91 AmeriHealth Caritas of NC — Managed Medicaid: $10.95 AmeriHealth Caritas SC — Medicare: $6.91 AmeriHealth Mercy Health Plans — Managed Medicaid: $7.50 Centene Absolute Total Care — Managed Medicaid: $7.74 Centene Ambetter — Centene Ambetter: $6.91 Centene Carolina Complete Health — Managed Medicai: $10.95 Centene Magnolia Health Services — Mgd. Medicaid: $6.01

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$1,214.30	$1,214.30	$90.39 – $301.22
CT scan of the head or brain, without contrast: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $107.41 Aetna Better Health of PA — Managed Medicaid: $116.75 Aetna National — Commercial: $155.71 AmeriHealth Caritas NC — Marketplace Medicare: $123.52 AmeriHealth Caritas SC — Medicare: $123.52 AmeriHealth Mercy Health Plans — Managed Medicaid: $116.75 Centene Absolute Total Care — Managed Medicaid: $246.97 Centene Ambetter — Centene Ambetter: $123.52 Centene Magnolia Health Services — Mgd. Medicaid: $107.41 Centene PA Health and Wellness — Mgd. Medicaid: $116.75
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$3,333.10	$3,333.10	$269.20 – $1,300.90
MRI of the brain, before and after contrast: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $358.42 Aetna Better Health of PA — Managed Medicaid: $339 Aetna National — Commercial: $469.38 AmeriHealth Caritas NC — Marketplace Medicare: $412.18 AmeriHealth Caritas SC — Medicare: $412.18 AmeriHealth Mercy Health Plans — Managed Medicaid: $339 Centene Absolute Total Care — Managed Medicaid: $1,300.90 Centene Ambetter — Centene Ambetter: $412.18 Centene Magnolia Health Services — Mgd. Medicaid: $358.42 Centene PA Health and Wellness — Mgd. Medicaid: $339
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$335.50	$335.50	$14.34 – $125.17
Chest X-ray, 2 views: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $89.41 Aetna Better Health of PA — Managed Medicaid: $23.64 Aetna National — Commercial: $48.32 AmeriHealth Caritas NC — Marketplace Medicare: $102.82 AmeriHealth Caritas SC — Medicare: $102.82 AmeriHealth Mercy Health Plans — Managed Medicaid: $23.64 Centene Absolute Total Care — Managed Medicaid: $14.34 Centene Ambetter — Centene Ambetter: $102.82 Centene Magnolia Health Services — Mgd. Medicaid: $89.41 Centene PA Health and Wellness — Mgd. Medicaid: $23.64
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY EXAM L-2 SPINE 4/>VWS	$468.30	$468.30	$36.62 – $150.37
X-ray of the lower spine, at least 4 views: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $107.41 Aetna Better Health of PA — Managed Medicaid: $36.62 Aetna National — Commercial: $74.68 AmeriHealth Caritas NC — Marketplace Medicare: $123.52 AmeriHealth Caritas SC — Medicare: $123.52 AmeriHealth Mercy Health Plans — Managed Medicaid: $36.62 Centene Absolute Total Care — Managed Medicaid: $47.83 Centene Ambetter — Centene Ambetter: $123.52 Centene Magnolia Health Services — Mgd. Medicaid: $107.41 Centene PA Health and Wellness — Mgd. Medicaid: $36.62
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$6,065	$6,065	$161.72 – $653.72
MRI of the lower back (lumbar spine), without contrast: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $245.13 Aetna Better Health of PA — Managed Medicaid: $256.15 Aetna National — Commercial: $281.93 AmeriHealth Caritas NC — Marketplace Medicare: $281.90 AmeriHealth Caritas SC — Medicare: $281.90 AmeriHealth Mercy Health Plans — Managed Medicaid: $256.15 Centene Absolute Total Care — Managed Medicaid: $653.72 Centene Ambetter — Centene Ambetter: $281.90 Centene Magnolia Health Services — Mgd. Medicaid: $245.13 Centene PA Health and Wellness — Mgd. Medicaid: $256.15
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$1,849.10	$1,849.10	$140.09 – $423.89
CT scan of the pelvis, with contrast: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $180.20 Aetna Better Health of PA — Managed Medicaid: $140.09 Aetna National — Commercial: $337.47 AmeriHealth Caritas NC — Marketplace Medicare: $207.23 AmeriHealth Caritas SC — Medicare: $207.23 AmeriHealth Mercy Health Plans — Managed Medicaid: $140.09 Centene Absolute Total Care — Managed Medicaid: $357.60 Centene Ambetter — Centene Ambetter: $207.23 Centene Magnolia Health Services — Mgd. Medicaid: $180.20 Centene PA Health and Wellness — Mgd. Medicaid: $140.09
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$2,175.90	$2,175.90	$171.28 – $647.42
MRI of a leg joint (such as the knee), without contrast: 10 of 28 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $245.13 Aetna National — Commercial: $298.85 AmeriHealth Caritas NC — Marketplace Medicare: $281.90 AmeriHealth Caritas SC — Medicare: $281.90 Centene Absolute Total Care — Managed Medicaid: $585.70 Centene Ambetter — Centene Ambetter: $281.90 Centene Magnolia Health Services — Mgd. Medicaid: $245.13 Centene Wellcare of KY — Managed Medicaid: $245.13 Cigna — Commercial: $281.65 Horizon Blue Cross Blue Shield of NJ — Commercial: $495
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$3,558.20	$3,558.20	$206.27 – $501.79
CT scan of the abdomen and pelvis, with contrast: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $358.42 Aetna Better Health of PA — Managed Medicaid: $263.16 Aetna National — Commercial: $446.73 AmeriHealth Caritas NC — Marketplace Medicare: $412.18 AmeriHealth Caritas SC — Medicare: $412.18 AmeriHealth Mercy Health Plans — Managed Medicaid: $263.16 Centene Absolute Total Care — Managed Medicaid: $357.60 Centene Ambetter — Centene Ambetter: $412.18 Centene Magnolia Health Services — Mgd. Medicaid: $358.42 Centene PA Health and Wellness — Mgd. Medicaid: $263.16
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$726.90	$726.90	$56 – $166.86
Ultrasound of the abdomen, complete: 10 of 36 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $107.41 Aetna Better Health of PA — Managed Medicaid: $95.27 Aetna National — Commercial: $166.86 AmeriHealth Caritas NC — Marketplace Medicare: $123.52 AmeriHealth Caritas SC — Medicare: $123.52 AmeriHealth Mercy Health Plans — Managed Medicaid: $95.27 Centene Absolute Total Care — Managed Medicaid: $103.15 Centene Ambetter — Centene Ambetter: $123.52 Centene Magnolia Health Services — Mgd. Medicaid: $107.41 Centene PA Health and Wellness — Mgd. Medicaid: $95.27

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$687.60	$687.60	$8.38 – $139
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 34 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $29.95 Aetna Better Health of PA — Managed Medicaid: $8.38 Aetna National — Commercial: $41.72 AmeriHealth Caritas NC — Marketplace Medicare: $34.44 AmeriHealth Caritas SC — Medicare: $34.44 AmeriHealth Mercy Health Plans — Managed Medicaid: $8.38 Centene Absolute Total Care — Managed Medicaid: $12.33 Centene Ambetter — Centene Ambetter: $34.44 Centene Magnolia Health Services — Mgd. Medicaid: $29.95 Centene PA Health and Wellness — Mgd. Medicaid: $8.38
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: THERAPEUTIC EXERCISES	$171.90	$171.90	$12.33 – $167
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 27 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $29.95 AmeriHealth Caritas NC — Marketplace Medicare: $34.44 AmeriHealth Caritas SC — Medicare: $34.44 Centene Absolute Total Care — Managed Medicaid: $12.33 Centene Ambetter — Centene Ambetter: $34.44 Centene Magnolia Health Services — Mgd. Medicaid: $29.95 Centene Wellcare of KY — Managed Medicaid: $29.95 Cigna — Commercial: $130 Horizon Blue Cross Blue Shield of NJ — Commercial: $80 Humana SC — Managed Medicaid: $12.33
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$687.60	$687.60	$12.33 – $167
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 27 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $29.95 AmeriHealth Caritas NC — Marketplace Medicare: $34.44 AmeriHealth Caritas SC — Medicare: $34.44 Centene Absolute Total Care — Managed Medicaid: $12.33 Centene Ambetter — Centene Ambetter: $34.44 Centene Magnolia Health Services — Mgd. Medicaid: $29.95 Centene Wellcare of KY — Managed Medicaid: $29.95 Cigna — Commercial: $130 Horizon Blue Cross Blue Shield of NJ — Commercial: $80 Humana SC — Managed Medicaid: $12.33
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$212.30	$212.30	$49.04 – $163
Physical therapy evaluation (low complexity): 10 of 27 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 Aetna National — Commercial: $142.73 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 Centene Absolute Total Care — Managed Medicaid: $49.04 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene Peach State Health — Managed Medicaid: $69.34 Centene Wellcare of KY — Managed Medicaid: $100.74 Cigna — Commercial: $130
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$212.30	$212.30	$49.04 – $167
Physical therapy evaluation (low complexity): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 Aetna Better Health of PA — Managed Medicaid: $63.61 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 AmeriHealth Mercy Health Plans — Managed Medicaid: $63.61 Centene Absolute Total Care — Managed Medicaid: $49.04 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene PA Health and Wellness — Mgd. Medicaid: $63.61 Centene Wellcare of KY — Managed Medicaid: $100.74
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$212.30	$212.30	$63.61 – $167
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 Aetna Better Health of PA — Managed Medicaid: $63.61 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 AmeriHealth Mercy Health Plans — Managed Medicaid: $63.61 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene PA Health and Wellness — Mgd. Medicaid: $63.61 Centene Wellcare of KY — Managed Medicaid: $100.74 Cigna — Commercial: $130
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP_U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$318.50	$318.50	$49.04 – $167
Physical therapy evaluation (moderate complexity): 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 Aetna Better Health of PA — Managed Medicaid: $63.61 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 AmeriHealth Mercy Health Plans — Managed Medicaid: $63.61 Centene Absolute Total Care — Managed Medicaid: $49.04 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene PA Health and Wellness — Mgd. Medicaid: $63.61 Centene Wellcare of KY — Managed Medicaid: $100.74
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier U8 In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$318.50	$318.50	$63.61 – $167
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 Aetna Better Health of PA — Managed Medicaid: $63.61 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 AmeriHealth Mercy Health Plans — Managed Medicaid: $63.61 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene PA Health and Wellness — Mgd. Medicaid: $63.61 Centene Wellcare of KY — Managed Medicaid: $100.74 Cigna — Commercial: $130
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$318.50	$318.50	$49.04 – $167
Physical therapy evaluation (moderate complexity): 10 of 27 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 Centene Absolute Total Care — Managed Medicaid: $49.04 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene Wellcare of KY — Managed Medicaid: $100.74 Cigna — Commercial: $130 Horizon Blue Cross Blue Shield of NJ — Commercial: $80 Humana SC — Managed Medicaid: $49.04
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$477.80	$477.80	$49.04 – $167
Physical therapy evaluation (high complexity): 10 of 27 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $100.74 AmeriHealth Caritas NC — Marketplace Medicare: $115.85 AmeriHealth Caritas SC — Medicare: $115.85 Centene Absolute Total Care — Managed Medicaid: $49.04 Centene Ambetter — Centene Ambetter: $115.85 Centene Magnolia Health Services — Mgd. Medicaid: $100.74 Centene Wellcare of KY — Managed Medicaid: $100.74 Cigna — Commercial: $130 Horizon Blue Cross Blue Shield of NJ — Commercial: $80 Humana SC — Managed Medicaid: $49.04

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$4,493.12	$4,493.12	$77.20 – $1,272.14
Nerve root injection, lower back, with imaging guidance: 10 of 35 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $908.67 Aetna Better Health of PA — Managed Medicaid: $95.04 AmeriHealth Caritas NC — Marketplace Medicare: $1,044.97 AmeriHealth Caritas SC — Medicare: $1,044.97 AmeriHealth Mercy Health Plans — Managed Medicaid: $95.04 Centene Absolute Total Care — Managed Medicaid: $293.65 Centene Ambetter — Centene Ambetter: $1,044.97 Centene Magnolia Health Services — Mgd. Medicaid: $908.67 Centene PA Health and Wellness — Mgd. Medicaid: $95.04 Centene Peach State Health — Managed Medicaid: $77.20
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CARPAL TUNNEL SURGERY	$9,477.42	$9,477.42	$300 – $2,808.61
Carpal tunnel release: 10 of 34 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $2,006.15 Aetna Better Health of PA — Managed Medicaid: $300 AmeriHealth Caritas NC — Marketplace Medicare: $2,307.07 AmeriHealth Caritas SC — Medicare: $2,307.07 AmeriHealth Mercy Health Plans — Managed Medicaid: $300 Centene Absolute Total Care — Managed Medicaid: $1,339.05 Centene Ambetter — Centene Ambetter: $2,307.07 Centene Magnolia Health Services — Mgd. Medicaid: $2,006.15 Centene PA Health and Wellness — Mgd. Medicaid: $300 Centene Peach State Health — Managed Medicaid: $311.31
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$5,184.60	$5,184.60	$650 – $4,501
Carpal tunnel release: 10 of 25 insurance plan rates Aetna Better Health of MI — Managed Medicaid: $2,006.15 Aetna National — Commercial: $1,486 AmeriHealth Caritas NC — Marketplace Medicare: $2,307.07 AmeriHealth Caritas SC — Medicare: $2,307.07 Centene Ambetter — Centene Ambetter: $2,307.07 Centene Magnolia Health Services — Mgd. Medicaid: $2,006.15 Centene Wellcare of KY — Managed Medicaid: $2,006.15 Cigna — Commercial: $1,248 Horizon Blue Cross Blue Shield of NJ — Commercial: $1,928 Independence Blue Cross — Commercial: $650

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$2,113 – $106,162.10
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 20 insurance plan rates AmeriHealth Caritas NC — Marketplace Medicare: $106,162.10 AmeriHealth Caritas of NC — Managed Medicaid: $26,101.40 AmeriHealth Caritas SC — Medicare: $106,162.10 Capital District Health Plan — Commercial: $3,895 Centene Ambetter — Centene Ambetter: $106,162.10 Centene Arkansas Total Care — Managed Medicaid: $3,137 Centene Carolina Complete Health — Managed Medicai: $31,432.24 Centene Wellcare of KY — Managed Medicaid: $51,586.38 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Providence Health Plan — Managed Medicaid: $75,336.49
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal fusion except cervical without major comorbid conditions or complications	Not listed in the file	Not listed in the file	$2,113 – $3,895
Spinal fusion (not neck), without major complications: rates for 10 insurance plans Capital District Health Plan — Commercial: $3,895 Centene Arkansas Total Care — Managed Medicaid: $3,137 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Alliance Coal Health Plan — Commercial: 85% (a percentage in the contract, not a dollar amount) Health Smart — Preferred Care: 85% (a percentage in the contract, not a dollar amount) Multiplan — Commercial: 85% (a percentage in the contract, not a dollar amount) Prime Health Services — Commercial: 85% (a percentage in the contract, not a dollar amount) Sana Benefits — Commercial: 70% (a percentage in the contract, not a dollar amount) Sentara Health Administration — Commercial: 40% (a percentage in the contract, not a dollar amount) Stratose — Commercial: 85% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY	Not listed in the file	Not listed in the file	$2,113 – $20,740.50
Hip or knee replacement (major joint of the leg), without major complications: 10 of 20 insurance plan rates AmeriHealth Caritas NC — Marketplace Medicare: $20,740.50 AmeriHealth Caritas of NC — Managed Medicaid: $5,099.33 AmeriHealth Caritas SC — Medicare: $20,740.50 Capital District Health Plan — Commercial: $3,895 Centene Ambetter — Centene Ambetter: $20,740.50 Centene Arkansas Total Care — Managed Medicaid: $3,137 Centene Carolina Complete Health — Managed Medicai: $5,926.37 Centene Wellcare of KY — Managed Medicaid: $10,078.24 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Providence Health Plan — Managed Medicaid: $14,718.21
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,113 – $26,041.40
Neck (cervical) spinal fusion, without complications: 10 of 20 insurance plan rates AmeriHealth Caritas NC — Marketplace Medicare: $26,041.40 AmeriHealth Caritas of NC — Managed Medicaid: $6,402.63 AmeriHealth Caritas SC — Medicare: $26,041.40 Capital District Health Plan — Commercial: $3,895 Centene Ambetter — Centene Ambetter: $26,041.40 Centene Arkansas Total Care — Managed Medicaid: $3,137 Centene Carolina Complete Health — Managed Medicai: $6,499.45 Centene Wellcare of KY — Managed Medicaid: $12,654.06 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Providence Health Plan — Managed Medicaid: $18,479.92
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$2,113 – $13,185.70
Uterus and ovary surgery (not for cancer), without complications: 10 of 20 insurance plan rates AmeriHealth Caritas NC — Marketplace Medicare: $13,185.70 AmeriHealth Caritas of NC — Managed Medicaid: $3,241.88 AmeriHealth Caritas SC — Medicare: $13,185.70 Capital District Health Plan — Commercial: $3,895 Centene Ambetter — Centene Ambetter: $13,185.70 Centene Arkansas Total Care — Managed Medicaid: $3,137 Centene Carolina Complete Health — Managed Medicai: $2,740.20 Centene Wellcare of KY — Managed Medicaid: $6,407.21 Horizon Blue Cross Blue Shield of NJ — Commercial: $2,113 Providence Health Plan — Managed Medicaid: $9,357.05

Source: Shriners Hospitals for Children - Philadelphia’s standard charges file (apim.services.craneware.com, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on March 19, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Children's Hospital
Address	3551 N Broad Street, Philadelphia, PA 19104
County	Philadelphia County
State	Pennsylvania
Phone	(215) 430‑4000
Emergency services	Not listed
Ownership	Voluntary non-profit - Other
Medicare overall rating	Not rated by CMS
CMS Certification Number	393309
Name in Medicare records	SHRINERS HOSPITALS FOR CHILDREN - PHILADELPHIA
Profile level	Medicare data + hospital website
Name on the hospital’s website	Shriners Children's Philadelphia
Official website	shrinerschildrens.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Shriners Children's Philadelphia — shrinerschildrens.org
Getting Here - Shriners Children's Philadelphia — shrinerschildrens.org
Amenities & Services | Shriners Children's Philadelphia — shrinerschildrens.org
Visiting Shriners Children's Philadelphia | Children's Hospital — shrinerschildrens.org
Patient Programs | Shriners Children's Philadelphia — shrinerschildrens.org
Fracture, Sports Injury and Other Specialty Clinics | Shriners Children's — shrinerschildrens.org
About Us | Shriners Children's Philadelphia — shrinerschildrens.org
Our Treatment Approach | Shriners Children’s Philadelphia — shrinerschildrens.org
Research | Shriners Children's Philadelphia — shrinerschildrens.org
our-care — shrinerschildrens.org