Jefferson Methodist Hospital — price list

← Hospital overviewVerified from Jefferson Methodist Hospital’s published price file

Includes insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.

How to read these columns

List: The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
Cash: The discounted self-pay price for paying directly, without insurance.
Negotiated: Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.

These are the hospital’s published reference prices, not a personalized estimate of your bill.

1,490 prices shown.

Service	Code	List price	Cash price	Negotiated range	Allowed (median)
1- Mohs addl stage t a l Outpatient	17314 CPT	—	—	$167 – $5,750	—
1- Mohs surg addl block Outpatient	17315 CPT	—	—	$47.36 – $5,750	—
1- Place rt device marker pros Outpatient	55876 CPT	—	—	$524 – $5,750	—
1- STAGE PERINEAL HYPOSPADIAS REPAIR RE Outpatient	54336 CPT	—	—	$1,009 – $11,938	—
1-1ANOSCOPY DIAGNOSTIC WITH HIGH- RESOLUTION MAGNIFICATION HRA EG COLPOSCOPE OPERATING MICROSCOPE AND CHEMICAL AGENT ENHANCEMENT INCLUDING CO Outpatient	46601 CPT	—	—	$77.28 – $5,750	—
1-1ANOSCOPY WITH HIGH-RESOLUTION MAGNIFICATION HRA EG COLPOSCOPE OPERATING MICROSCOPE AND CHEMICAL AGENT ENHANCEMENT WITH BIOPSY SINGLE OR MU Outpatient	46607 CPT	—	—	$787 – $5,750	—
1-1ARTHROCENTESIS ASPIRATION AND OR INJECTION INTERMEDIATE JOINT OR BURSA EG TEMPOROMANDIBULAR ACROMIOCLAVICULAR WRIST ELBOW OR ANKLE OLECRANO Outpatient	20606 CPT	—	—	$55.06 – $5,750	—
1-1ARTHROCENTESIS ASPIRATION AND OR INJECTION MAJOR JOINT OR BURSA EG SHOULDER HIP KNEE SUBACROMIAL BURSA WITH ULTRASOUND GUIDANCE WITH PERM Outpatient	20611 CPT	—	—	$64.77 – $5,750	—
1-1ARTHROCENTESIS ASPIRATION AND OR INJECTION INTERMEDIATE JOINT OR BURSA EG TEMPOROMANDIBULAR ACROMIOCLAVICULAR WRIST ELBOW OR ANKLE OLECRANO Outpatient	20606 CPT	—	—	$55.06 – $5,750	—
1-1ARTHROCENTESIS ASPIRATION AND OR INJECTION MAJOR JOINT OR BURSA EG SHOULDER HIP KNEE SUBACROMIAL BURSA WITH ULTRASOUND GUIDANCE WITH PERM Outpatient	20611 CPT	—	—	$64.77 – $5,750	—
1-1ARTHROCENTESIS ASPIRATION AND OR INJECTION SMALL JOINT OR BURSA EG FINGERS TOES WITH ULTRASOUND WITH PERMANENT RECORDING AND REPORTING Outpatient	20604 CPT	—	—	$48.17 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ABLATION OF TUMOR S POLYP S OR OTHER LESION S INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE WHEN PE Outpatient	44401 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH DIRECTED SUBMUCOSAL INJECTION S ANY SUBSTANCE Outpatient	44404 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC MUCOSAL RESECTION Outpatient	44403 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC STENT PLACEMENT INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE WHEN PERFORMED Outpatient	44402 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH TRANSENDOSCOPIC BALLOON DILATION Outpatient	44405 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH DIRECTED SUBMUCOSAL INJECTION S ANY SUBSTANCE Outpatient	44404 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC MUCOSAL RESECTION Outpatient	44403 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC STENT PLACEMENT INCLUDING PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE WHEN PERFORMED Outpatient	44402 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH TRANSENDOSCOPIC BALLOON DILATION Outpatient	44405 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ABLATION OF TUMOR S POLYP S OR OTHER LESION S INCLUDES PRE-AND POST-DILATION AND GUIDE WIRE PASSAGE WHEN PER Outpatient	44401 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION FOR PATHOLOGIC DISTENTION EG VOLVULUS MEGACOLON INCLUDING PLACEMENT OF DECOMPRESSION TUBE WHE Outpatient	44408 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC ULTRASOUND EXAMINATION LIMITED TO THE SIGMOID DESCENDING TRANSVERSE OR ASCENDING COLON AND CECUM AND Outpatient	44406 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH ENDOSCOPIC ULTRASOUND EXAMINATION LIMITED TO THE SIGMOID DESCENDING TRANSVERSE OR ASCENDING COLON AND CECUM AND Outpatient	44406 CPT	—	—	$1,009 – $5,750	—
1-1COLONOSCOPY THROUGH STOMA WITH TRANSENDOSCOPIC ULTRASOUND GUIDED INTRAMURAL OR TRANSMURAL FINE NEEDLE ASPIRATION BIOPSY S INCLUDES ENDOSCOPIC UL Outpatient	44407 CPT	—	—	$1,009 – $5,750	—
1-1MYELOGRAPHY VIA LUMBAR INJECTION INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION CERVICAL Outpatient	62302 CPT	—	—	$131 – $12,000	—
1-1MYELOGRAPHY VIA LUMBAR INJECTION INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION LUMBOSACRAL Outpatient	62304 CPT	—	—	$129 – $12,000	—
1-1MYELOGRAPHY VIA LUMBAR INJECTION INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION THORACIC Outpatient	62303 CPT	—	—	$133 – $12,000	—
1-1MYELOGRAPHY VIA LUMBAR INJECTION INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION CERVICAL Outpatient	62302 CPT	—	—	$131 – $12,000	—
1-1MYELOGRAPHY VIA LUMBAR INJECTION INCLUDING RADIOLOGICAL SUPERVISION AND INTERPRETATION LUMBOSACRAL Outpatient	62304 CPT	—	—	$129 – $12,000	—