Medical Procedure Costs in Pennsylvania

Pennsylvania medical procedure costs are generally near the national average. Medicare divides Pennsylvania into 2 pricing localities, so costs can vary within the state.

Cost vs National Avg

-0.6%

Close to average

Pricing Localities

Medicare pricing regions

Procedures Covered

7,500+

CPT codes with pricing

Pricing Regions in Pennsylvania

Locality	Work GPCI	PE GPCI	MP GPCI
metropolitan philadelphia	1.018	1.041	1.193
rest of pennsylvania	1.000	0.918	0.945

GPCI (Geographic Practice Cost Index) values adjust Medicare payments for regional cost differences. Higher values mean higher costs. A GPCI of 1.000 equals the national average.

Procedure Costs in Pennsylvania

Procedure	Pennsylvania	National Avg	Difference
Incision & Drainage of Abscess	$128	$129	-0.8%
Skin Biopsy (Tangential)	$94	$96	-1.2%
Skin Biopsy (Punch)	$120	$121	-1.2%
Destruction of Skin Lesion	$66	$66	-0.9%
Partial Mastectomy	$637	$633	+0.7%
Total Hip Replacement	$1,169	$1,162	+0.6%
Total Knee Replacement	$1,166	$1,159	+0.6%
Knee Arthroscopy	$516	$516	+0.1%
Upper Endoscopy (EGD)	$319	$323	-1.2%
Upper Endoscopy (EGD) With Biopsy	$413	$419	-1.3%
Colonoscopy (Diagnostic)	$375	$378	-0.9%
Colonoscopy With Biopsy	$475	$480	-1.1%
Colonoscopy With Polyp Removal	$496	$500	-0.9%
Laparoscopic Cholecystectomy	$637	$632	+0.8%
Laparoscopic Inguinal Hernia Repair	$426	$424	+0.5%
Laparoscopic Removal of Ovarian Cyst	$591	$586	+0.9%
Vaginal Delivery (Global)	$2,237	$2,214	+1.0%
Cesarean Delivery (Global)	$2,502	$2,473	+1.2%
Lumbar Discectomy	$903	$898	+0.5%
Cataract Surgery	$462	$463	-0.2%
MRI Brain Without Contrast	$193	$195	-1.2%
MRI Brain With Contrast	$265	$269	-1.3%
MRI Brain	$313	$317	-1.2%
Chest X-Ray	$33	$33	-1.2%
CT Chest Without Contrast	$131	$133	-1.1%
CT Chest With Contrast	$165	$167	-1.2%
MRI Cervical Spine	$189	$191	-1.1%
MRI Lumbar Spine	$190	$192	-1.2%
Shoulder X-Ray	$35	$36	-1.4%
MRI Shoulder	$202	$205	-1.3%
Knee X-Ray	$34	$34	-1.4%
MRI Knee	$202	$204	-1.3%
CT Abdomen & Pelvis Without Contrast	$181	$183	-1.0%
CT Abdomen & Pelvis With Contrast	$296	$300	-1.3%
Ultrasound Abdomen	$113	$114	-1.2%
Ultrasound Transvaginal	$116	$118	-1.3%
Ultrasound Pelvis	$104	$105	-1.3%
Diagnostic Mammogram	$155	$157	-1.3%
Screening Mammogram	$125	$126	-1.4%
Nuclear Stress Test	$421	$428	-1.6%
Psychiatric Evaluation	$174	$173	+0.2%
Psychiatric Evaluation With Medical Services	$203	$202	+0.2%
Psychotherapy (45 min)	$114	$114	+0.2%
Psychotherapy (60 min)	$167	$167	+0.2%
ECG/EKG	$15	$15	-0.5%
Echocardiogram	$194	$197	-1.2%
Stress Echocardiogram	$183	$185	-1.2%
Carotid Ultrasound	$186	$189	-1.5%
Laser Treatment for Skin	$136	$138	-1.4%
Physical Therapy (Therapeutic Exercise)	$29	$29	-0.4%
Physical Therapy (Manual Therapy)	$28	$28	-0.4%
PT Evaluation (Low Complexity)	$97	$98	-0.5%
PT Evaluation (Moderate Complexity)	$97	$98	-0.5%
Office Visit (New, Low)	$117	$118	-0.3%
Office Visit (New, Moderate-High)	$177	$177	-0.2%
Office Visit (New, High)	$236	$237	-0.1%
Office Visit (Established, Moderate)	$95	$95	-0.4%
Office Visit (Established, Moderate-High)	$135	$136	-0.3%
Office Visit (Established, High)	$192	$192	-0.3%

Prices shown are Medicare office (non-facility) rates. Click any procedure for full details including hospital rates and savings tips.

Understanding Medical Costs in Pennsylvania

Medical procedure costs in Pennsylvania are determined by Medicare's Geographic Practice Cost Indices (GPCIs), which account for differences in physician work, practice expenses, and malpractice insurance across regions. Because Pennsylvania has 2 different pricing localities, costs can vary significantly depending on where within the state the procedure is performed.

The prices listed above represent Medicare reimbursement rates, which serve as a baseline for what healthcare costs in Pennsylvania. Private insurance companies typically negotiate rates between 130% and 200% of these Medicare amounts. If you are paying out of pocket, many providers in Pennsylvania offer cash discounts of 20% to 40% off their standard charges.

For the most accurate pricing, enter your ZIP code on any procedure page to see costs adjusted for your specific locality within Pennsylvania.

Ways to Save on Medical Costs in Pennsylvania

Compare Insurance Plans

Comparing marketplace plans in Pennsylvania could save you thousands on procedures.

Compare plans on eHealth →

Try Telehealth First

Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.

Book on Sesame Care →

Save on Prescriptions

If a procedure leads to a prescription, discount cards can save up to 80% at pharmacies.

Check prices on GoodRx →

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Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts and may not reflect actual charges. Private insurance and self-pay estimates are approximations.