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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in GA

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Hospitals
8
Min
$264.60
Median
$969.33
Max
$1,159.00
Range multiplier
4.4×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield519$58.84$1,816.56$3,206.4454.5×
Aetna619$226.80$999.27$11,58451.1×
UnitedHealthcare618$1.00$905.26$2,305.502305.5×
Cigna514$1.00$1,655.86$2,846.202846.2×
Humana613$127.31$860.00$1,265.009.9×
WellCare511$252.00$793.57$1,049.244.2×
First Health39$239.40$2,517.50$3,420.0014.3×
CareSource37$659.61$832.47$1,584.212.4×
Health Net16$127.31$625.64$2,570.5020.2×
Medicaid14$1.00$209.54$844.14844.1×
Ambetter34$1,040.54$1,296.68$1,552.821.5×
banner health13$127.31$252.00$999.277.8×
peach state13$12.84$932.42$1,086.3184.6×
Oscar Health23$1,176.84$1,505.76$1,505.761.3×
devoted health23$267.12$932.42$1,059.234.0×
arizona medical network12$252.00$625.64$999.274.0×
alliant op rate22$1,900.00$1,900.00$1,900.001.0×
amerigroup op rate22$579.22$693.50$807.771.4×
beech street op rate22$3,420.00$3,420.00$3,420.001.0×
blue mcr replacement12$941.10$941.10$941.101.0×
bridgeway health solutions12$252.00$625.64$999.274.0×
dodge cty op rate22$912.00$912.00$912.001.0×
facility billing - op12$941.10$941.10$941.101.0×
health choice pathway12$252.00$625.64$999.274.0×
health management network12$252.00$625.64$999.274.0×
healthspring mcr replacement12$950.51$955.22$959.921.0×
imperial insurance12$264.60$656.92$1,049.244.0×
Medicare Advantage12$941.10$941.10$941.101.0×
occunet12$1,741.04$1,929.26$2,117.471.2×
phcs op rate22$3,496.00$3,496.00$3,496.001.0×
riverwood behavioral health12$905.26$1,018.42$1,131.581.3×
rural arizona network12$252.00$625.64$999.274.0×
secure health op rate22$1,900.00$1,900.00$1,900.001.0×
smarthealth12$1,317.54$1,317.54$1,317.541.0×
sonder health plan12$950.52$950.52$950.521.0×
united mine workers of america12$252.00$625.64$999.274.0×
Multiplan11$905.26$905.26$905.261.0×
naphcare11$1,403.15$1,403.15$1,403.151.0×
novanet11$905.26$905.26$905.261.0×
TRICARE11$905.26$905.26$905.261.0×
care 1st11$127.31$127.31$127.311.0×
acchs11$127.31$127.31$127.311.0×
peach state health plan op rate11$648.17$648.17$648.171.0×
peach state hp op rate11$817.51$817.51$817.511.0×
employer direct healthcare11$1,267.36$1,267.36$1,267.361.0×
georgia workers’ compensation11$905.26$905.26$905.261.0×
health choice11$133.68$133.68$133.681.0×
americas choice provider network11$905.26$905.26$905.261.0×
prime health services11$905.26$905.26$905.261.0×
corvel11$905.26$905.26$905.261.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Marys Sacred Heart HospitalLavoniaGA12$941.10$969.33$11,584
Southern Regional Medical CenterRiverdaleGA26$4,131.95$905.00$12.84$905.26$2,297.20
Dodge County HospitalEastmanGA6$1,582.27$1.00$790.92$1,700.00
West Central Ga Regional HospitalColumbusGA22$2,650.00$1,966.30$127.31$264.60$2,570.50
Perry HospitalPerryGA16$1,672.30$579.22$1,159.00$3,496.00
Houston Medical CenterWarner RobinsGA16$1,672.30$743.25$1,159.00$3,496.00
Southwell MedicalAdelGA0$2,188.00$1,094.00
Union General HospitalBlairsvilleGA0

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.