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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in CA

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Hospitals
38
Min
$364.00
Median
$1,160.81
Max
$5,603.00
Range multiplier
15.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield35124$204.47$2,382.67$61,772302.1×
Anthem BCBS30110$204.47$1,288.77$10,96553.6×
UnitedHealthcare2479$405.42$4,390.00$252,199622.1×
Medicaid2271$318.26$567.59$2,025.106.4×
Aetna3157$204.47$2,272.00$30,886151.1×
Health Net1647$224.87$1,160.81$4,209.0018.7×
Medicare3046$204.47$1,142.58$3,541.1017.3×
Kaiser Permanente2843$204.47$983.94$2,334.0511.4×
Cigna2039$133.12$3,968.00$9,344.0070.2×
Molina1027$321.48$1,160.81$61,772192.1×
Humana2224$204.47$1,037.37$8,864.0043.4×
brand new day612$1,172.42$1,456.82$1,741.221.5×
TRICARE611$1,160.81$1,160.81$1,160.811.0×
Empire BCBS28$466.15$1,160.81$1,451.013.1×
citrus valley physicians group26$1,160.81$1,160.81$1,160.811.0×
traditional medi-cal66$321.48$321.48$321.481.0×
ucsd [807]16$522.29$716.70$731.201.4×
aids healthcare foundation26$321.48$1,160.81$1,184.033.7×
emanate health26$1,160.81$1,160.81$2,321.622.0×
employer direct healthcare55$1,625.13$1,625.13$1,625.131.0×
First Health55$817.88$1,483.32$4,047.004.9×
renal payer solutions55$1,160.81$1,160.81$1,160.811.0×
commercial | hill physicians | all plans55$1,142.58$1,142.58$1,142.581.0×
Bright Health44$882.00$1,135.10$1,249.531.4×
community health group24$1,981.81$2,419.44$2,917.561.5×
alignment44$1,160.81$1,160.81$1,160.811.0×
vantage care24$321.48$741.15$1,160.813.6×
naphcare34$1,799.26$1,799.26$1,799.261.0×
Multiplan44$224.87$1,111.20$1,483.326.6×
commercial | connected care intel | all plans33$7,009.00$7,009.00$8,864.001.3×
managed health network33$1,160.81$1,160.81$2,668.502.3×
blue card (out of state) [40000]13$277.71$277.71$466.521.7×
l.a care health plan13$321.48$1,160.81$1,160.813.6×
la care health plan13$321.48$1,160.81$1,160.813.6×
claritev [13400]13$283.71$403.20$403.201.4×
umr [17000]13$448.86$614.31$614.311.4×
shca comm intel [20300000]13$277.71$277.71$466.521.7×
beech st [10600]13$283.71$403.20$403.201.4×
imperial health plan of ca33$1,230.46$1,230.46$1,230.461.0×
commercial | mhn | all plans33$1,033.55$1,235.50$1,235.501.2×
central health plan33$1,160.81$1,160.81$1,160.811.0×
american specialty health plan alt payer [971000000]13$667.38$765.26$765.261.1×
health plan of san mateo [31200]13$140.08$196.11$196.111.4×
private healthcare systems (phcs) [14200]13$283.71$403.20$403.201.4×
indian health council23$1,209.72$2,739.66$2,917.562.4×
commercial | epic health | all plans22$1,348.05$1,348.05$1,348.051.0×
elite health plan22$1,160.81$1,160.81$1,160.811.0×
interplan22$1.15$854.50$1,707.841485.1×
corvel22$1,323.32$1,388.03$1,452.731.1×
commercial | valley care ipa | all plans22$991.00$991.00$991.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Bernardine Medical CenterSan BernardinoCA11$405.42$999.00$19,284
St Elizabeth Community HosptialRed BluffCA7$446.86$983.94$1,285.91
Mercy Medical Center MercedMercedCA9$357.41$982.43$12,552
St. Mary Medical CenterApple ValleyCA11$337.55$968.65$7,322.00
Community Hospital Of San BernardinoSan BernardinoCA13$405.42$961.95$9,063.00
Pacifica Hospital Of The ValleySun ValleyCA13$61,772$61,772$672.00$861.00$61,772
Scripps Mercy HospitalSan DiegoCA13$2,901.60$725.40$522.29$731.20$2,486.67
Mark Twain Medical CenterSan AndreasCA12$889.00$622.30$204.47$632.48$871.22
Dominican HospitalSanta CruzCA9$405.42$5,603.00$10,965
Methodist Hospital Of SacramentoSacramentoCA11$405.42$4,530.00$11,836
Stanford Health CareStanfordCA14$1,607.00$803.50$133.12$403.20$765.26
Mercy Medical Center Mt. ShastaMt. ShastaCA7$364.00$364.00$1,285.91
Mercy Hospital Of FolsomFolsomCA10$405.42$3,143.69$10,296
Marian Medical CenterSanta MariaCA10$405.42$3,137.00$9,264.00
Woodland HealthcareWoodlandCA7$405.42$2,720.68$6,280.00
St. Johns Regional Medical CenterOxnardCA11$490.56$2,641.05$16,750
Grossmont HospitalLa MesaCA3$3,558.00$2,668.50$1,779.00$2,535.08$2,917.56
Mercy San Juan Medical CenterCarmichaelCA11$405.42$2,365.92$252,199
Sharp Chula Vista Medical CenterChula VistaCA11$3,558.00$2,668.50$1.15$2,315.19$2,917.56
Sharp Memorial HospitalSan DiegoCA17$3,558.00$2,668.50$1.15$2,152.59$2,917.56
St. Johns Pleasant Valley HospitalCamarilloCA11$405.42$2,025.10$16,750
Glendale Memorial Hospital & Hlth CtGlendaleCA6$369.70$1,984.20$7,244.00
Central Valley Specialty HospitalModestoCA6$2,592.00$2,592.00$648.00$1,944.00$2,203.20
Mercy General HospitalSacramentoCA11$405.42$1,703.91$18,443
Saint Francis Memorial HospitalSan FranciscoCA15$395.26$1,459.18$8,443.00
Sequoia HospitalRedwood CityCA12$388.13$1,244.53$10,333
St. Marys Medical CenterSan FranciscoCA13$388.13$1,235.50$8,811.00
Garden Grove Hospital Medical CenterGarden GroveCA19$6,196.80$1,160.00$321.48$1,160.81$1,799.26
Encino HospitalEncinoCA27$2,230.47$1,160.00$321.48$1,160.81$1,741.22
Huntington Beach HospitalHuntington BeachCA16$6,196.80$1,160.00$321.48$1,160.81$1,741.22
Chino Valley Medical CenterChinoCA25$6,026.29$1,160.00$321.48$1,160.81$2,321.62
Sherman Oaks Hospital-HlthSherman OaksCA30$2,112.00$1,160.00$321.48$1,160.81$1,799.26
Montclair Hospital Medical CenterMontclairCA24$10,179$1,160.00$321.48$1,160.81$2,321.62
Sierra Nevada Memorial HospitalGrass ValleyCA9$405.42$1,142.58$11,058
St. Josephs Behavioral Hlth CenterStocktonCA2$1,081.30$1,081.30$1,081.30
St. Josephs Medical CenterStocktonCA2$1,081.30$1,081.30$1,081.30
Bakersfield Memorial HospitalBakersfieldCA11$405.42$1,037.66$9,954.00
Northridge Medical Center - RoscoeNorthridgeCA12$385.77$1,033.55$11,879

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.