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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in MI

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Hospitals
28
Min
$169.33
Median
$914.38
Max
$1,576.27
Range multiplier
9.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Medicare1385$108.6$865.08$1,463.0113.5×
Medicaid1381$77.75$512.85$2,004.325.8×
UnitedHealthcare2177$77.75$866.32$3,31942.7×
Aetna2262$139.96$977.33$11,58482.8×
Blue Cross Blue Shield1541$194.4$765.21$2,004.310.3×
Humana1941$108.6$914.38$1,075.069.9×
priority health op rate1017$232.32$976.96$3,112.713.4×
smarthealth816$1,317.54$1,317.54$1,368.261.0×
Ambetter816$1,552.82$1,552.82$1,583.271.0×
Medicare Advantage916$798.67$941.1$941.11.2×
healthspring mcr replacement714$950.51$955.22$959.921.0×
WellCare714$941.1$941.1$941.11.0×
Oscar Health714$1,505.76$1,505.76$1,505.761.0×
occunet714$1,741.04$1,929.26$2,117.471.2×
blue mcr replacement714$941.1$941.1$941.11.0×
facility billing - op714$941.1$941.1$941.11.0×
TRICARE1011$826.74$899.68$1,762.282.1×
priority health910$40$184.1$482.2512.1×
hap preferred op rate49$246.95$1,136.4$3,308.7213.4×
First Health89$169.45$2,004.3$3,265.519.3×
mclaren commercial ins88$233.16$233.16$233.161.0×
mclaren health op rate48$144.62$525.83$1,937.6313.4×
hap - hmo88$116.6$116.6$116.61.0×
hap - hmo op rate58$647.98$957.89$1,774.892.7×
u of m health plan88$124.89$124.89$124.891.0×
cofinity - auto op rate47$835.45$1,244.67$1,649.562.0×
mi amish medical board77$914.38$914.38$914.381.0×
hap ahl op rate26$246.95$856.72$3,308.7213.4×
hap hmo op rate26$227.43$817.06$3,047.1913.4×
health plus hmo op rate26$273.11$941.95$3,659.2913.4×
Cigna26$229.18$887.3$3,070.7313.4×
cofinity ppom op rate15$300.61$1,081.39$4,027.7813.4×
detroit medical center op rate15$140.95$507.03$1,888.513.4×
hp - hmo op rate45$866.86$1,245.03$1,576.271.8×
hp - ppo op rate45$1,154.68$1,656.83$2,187.111.9×
mclaren health advantage op rate24$567.59$709.79$783.931.4×
cofinity - ppom op rate34$1,358.13$2,355.38$3,284.72.4×
harbor health plan14$482.25$530.48$899.681.9×
hap - ppo op rate33$1,154.68$2,462.57$2,462.572.1×
health advantage - ppo op rate23$589.46$890.55$935.081.6×
total health care priority health13$482.25$885.55$899.681.9×
oakland county community mental health op rate13$1,076.2$1,237.6$1,486.41.4×
oc inmates correct care solutions llc op rate13$678.01$779.69$936.431.4×
cofinity and wc op rate13$748.93$861.25$1,034.391.4×
hcap op rate33$1,218.15$2,305.06$2,305.061.9×
mhp - hmo op rate23$589.46$890.55$935.081.6×
hap - preferred op rate13$818.88$941.69$1,1311.4×
bsbs bcn op rate13$338.17$381.97$1,070.023.2×
cofinity op rate22$1,254.69$1,273.02$1,291.351.0×
mi amish medical board op rate22$930.32$930.32$930.321.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ASCENSION PROVIDENCE ROCHESTER HOSPIROCHESTERMI12$941.1$969.33$11,584
BORGESS-PIPP HEALTH CENTERPLAINWELLMI12$941.1$969.33$11,584
ASCENSION ALLEGAN HOSPITALALLEGANMI12$941.1$969.33$11,584
ASCENSION BORGESS-LEE HOSPITALDOWAGIACMI12$941.1$969.33$11,584
ASCENSION BORGESS HOSPITALKALAMAZOOMI12$941.1$969.33$11,584
ASCENSION STANDISH HOSPITALSTANDISHMI12$941.1$969.33$11,584
GENESYS REGIONAL MEDICAL CTR.GRAND BLANCMI12$941.1$969.33$11,584
MCLAREN FLINTFLINTMI26$4,807.97$2,403.99$77.75$914.38$2,473.76
GARDEN CITY HOSPITAL OSTEOPATHICGARDEN CITYMI19$7,486.04$899$40$899.68$1,394.5
MCLAREN OAKLANDPONTIACMI14$772.95$493.86$835.45$1,486.4
KARMANOS CANCER HOSPITALDETROITMI15$2,558.95$140.95$792.95$4,027.78
MCLAREN LAPEER REGIONLAPEERMI24$8,105.9$4,052.95$77.75$745.6$2,004.3
MCLAREN PORT HURONPORT HURONMI29$5,408.63$2,704.32$77.75$643.78$1,624.2
BAY REGIONAL MEDICAL CENTERBAY CITYMI24$10,441$5,220.66$77.75$621.63$3,284.7
MCLAREN CENTRAL MICHIGANMT PLEASANTMI17$5,872.08$2,936.04$77.75$520.54$1,549.62
MCLAREN NORTHERN MICHIGANPETOSKEYMI15$3,999.77$1,999.89$77.75$512.85$1,463.01
MCLAREN GREATER LANSINGLANSING MI 489100MI20$6,631.05$3,315.53$77.75$512.85$1,463.01
ASCENSION ST JOHN HOSPITALDETROITMI3$139.96$313.57$313.57
MCLAREN THUMB REGIONBAD AXEMI11$4,959.58$2,479.79$77.75$169.33$1,762.28
MCLAREN BAY SPECIAL CAREBAY CITYMI17$1,920.88$410.95$1,576.27$3,284.7
MCLAREN MACOMBMT. CLEMENSMI20$1,142.2$135$1,242.91$1,900.8
TAWAS ST. JOSEPH HOSPITALTAWASMI9$977.33$1,026.2$1,583.27
MACKINAC STRAITS HEALTH SYSTEM INCST. IGNACEMI0$523$366.1
NORTH OTTAWA COMMUNITY HOSPITALGRAND HAVENMI0$6,616$4,631.2
CARSON CITY HOSPITALCARSON CITYMI0$569$284.5
MCKENZIE HEALTH SYSTEMSANDUSYMI0$572$457.6
SPARROW CLINTON HOSPITALST. JOHNSMI0$2,128$532
SPARROW EATONCHARLOTTEMI0$569$284.5

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.