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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in MA

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Hospitals
9
Min
$989.20
Median
$1,141.32
Max
$1,508.22
Range multiplier
1.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield656$52.12$870.88$3,236.0062.1×
UnitedHealthcare643$22.71$1,163.06$4,584.00201.8×
Medicaid435$2.89$9.49$2,328.18805.6×
institution [10406]432$7.59$1,100.43$3,236.00426.4×
harvard pilgrim [10701]424$745.36$761.55$1,335.021.8×
Cigna621$701.92$1,660.00$4,409.206.3×
Aetna619$24.88$1,975.00$5,350.00215.0×
correctional care [11003]316$1,086.97$1,093.70$3,563.913.3×
tufts [11201]412$701.92$2,158.43$2,374.303.4×
mgb mcr [10124]410$1,086.97$1,141.32$2,444.582.2×
tufts connectorcare [10507]410$1,848.94$1,848.94$3,960.232.1×
hsno/free care [10801]48$294.30$672.16$680.812.3×
CHAMPVA48$1,002.07$1,192.46$2,027.512.0×
tufts us family [11203]48$1,086.97$1,093.70$2,328.182.1×
tufts mcr supp [20209]28$570.66$855.99$1,141.322.0×
senior whole health [10110]48$1,163.06$1,170.26$2,491.152.1×
wellpoint [11112]48$1,508.22$1,508.22$1,508.221.0×
commonwealth care mcr [10115]37$1,141.32$1,141.32$2,444.582.1×
tufts dual [10111]37$1,086.97$1,086.97$2,328.182.1×
fallon mcr [10105]37$1,141.32$1,141.32$1,155.451.0×
tufts mcr [10112]27$570.66$1,155.45$2,444.584.3×
Medicare37$1,086.97$1,086.97$2,328.182.1×
grants [20507]46$6.52$2,502.00$3,236.00496.3×
fallon connectorcare [10503]26$377.00$608.16$2,178.765.8×
fallon mcr supp [20202]26$1,141.32$1,155.45$2,444.582.1×
First Health55$60.00$2,271.75$2,427.0040.5×
workers compensation [20501]45$379.98$995.63$1,294.403.4×
harvard pilgrim mcr supp [20203]24$1,141.32$1,141.32$1,141.321.0×
eternalhealth mcr replace [10116]24$1,141.32$1,141.32$1,141.321.0×
hne [11108]44$1,285.33$1,459.44$1,689.881.3×
pennsylvania health and wellness14$156.53$989.20$1,723.8311.0×
fallon mcaid carelon hlth [29]44$1,975.00$3,132.50$3,236.001.6×
geisinger14$150.26$1,509.54$2,211.8114.7×
connecticare [11105]44$1,975.00$3,132.50$3,236.001.6×
evernorth behavioral health [27]33$1,580.00$2,588.80$2,588.801.6×
masshealth mcd mbhp [38]33$1,975.00$3,236.00$3,236.001.6×
Multiplan33$2,271.75$2,427.00$2,427.001.1×
commonwealth care alliance [10103]13$1,141.32$1,155.45$1,155.451.0×
upmc health plan13$175.31$250.44$978.395.6×
amerihealth12$37.03$41.97$46.911.3×
fallon carelon hlth [28]22$1,975.00$2,502.00$3,029.001.5×
Humana22$959.75$1,005.81$1,051.871.1×
wellsense cc carelon hlth [20]22$3,236.00$3,236.00$3,236.001.0×
optum transplant [20601]22$3,236.00$3,236.00$3,236.001.0×
hp optum bh [32]22$1,975.00$2,502.00$3,029.001.5×
qualcare inc12$87.00$1,393.00$2,699.0031.0×
health partners plans12$978.39$1,096.20$1,214.001.2×
devon health12$3,858.26$3,858.26$3,858.261.0×
harvard pilgrim mcr [10106]12$1,155.45$1,800.02$2,444.582.1×
automobile [10401]22$3,236.00$3,236.00$3,236.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Chestnut Hill Benevolent AssociationChestnut HillMA19$3,937.00$150.26$989.20$5,350.00
Healthalliance-ClintonLeominsterMA32$8,377.23$8,377.23$294.30$1,508.22$4,409.20
Umass Memorial Medical CenterWorcesterMA37$18,411$18,411$2.89$1,141.32$3,563.91
Marlborough HospitalMarlboroughMA37$18,411$18,411$2.89$1,141.32$3,563.91
Harrington Memorial HospitalSouthbridgeMA31$7,342.66$7,342.66$111.82$1,141.32$1,975.00
Beth Israel Deaconess - PlymouthPlymouthMA13$4,881.00$22.71$1,051.87$4,584.00
Berkshire Medical CenterPittsfieldMA0$2,655.78$2,522.99
Fairview HospitalGreat BarringtonMA0$2,655.78$2,522.99
North Adams Regional HospitalNorth AdamsMA0$2,655.78$2,522.99

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.