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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in NY

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Hospitals
11
Min
$235.71
Median
$604.97
Max
$2,102.83
Range multiplier
8.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield7106$67.2$375.38$5,440.0181.0×
UnitedHealthcare960$79.52$400.78$10,588133.1×
Aetna950$96.56$752.8$9,784101.3×
Emblem Health446$80.8$1,029.26$5,536.0168.5×
Healthfirst331$110.49$867.77$5,536.0150.1×
Empire BCBS331$124.3$1,086.01$5,536.0144.5×
Medicaid225$68.68$195.73$973.6714.2×
mvp425$96.56$598.19$5,536.0157.3×
capital district physicians' health plan324$179.32$263.7$3,165.8117.7×
Medicare222$96.56$245.26$1,245.3912.9×
fidelis care422$96.56$127.8$1,203.8412.5×
Cigna512$147.3$711.73$6,53944.4×
Multiplan311$728.1$1,174.5$3,815.25.2×
magnacare511$647.2$1,316$3,527.55.5×
amerihealth110$131.48$206.61$1,164.948.9×
Humana610$96.56$798.14$1,176.0412.2×
[magnacare]110$766.8$981.8$2,021.62.6×
fidelis29$135.11$2,147.71$5,536.0141.0×
choicecare28$124.96$535.41$2,534.420.3×
[fidelis]16$138.11$1,045.3$2,342.8417.0×
martins point36$263.7$484.65$1,226.864.7×
mvp 290016$106.72$260.6$2,481.7323.3×
oxford26$649.57$1,365.68$8,40012.9×
VA Health36$113.6$409.6$1,203.8410.6×
geisinger16$181.57$200.35$457.62.5×
[metroplus]16$241.69$1,109.68$1,971.068.2×
[urn]15$830.7$1,017.9$1,794.172.2×
Molina34$117.95$1,834.89$5,536.0146.9×
[oxford]14$653.08$4,559.74$10,03815.4×
excellus 220114$96.56$281.38$488.75.1×
fidelis 515514$133.79$236.25$370.292.8×
First Health24$687.65$1,780.65$3,614.45.3×
harvard pilgrim24$647.2$1,653.2$3,212.85.0×
independent health 515614$148.45$260.17$406.682.7×
st. regis24$705.6$772$1,145.531.6×
univera14$98.89$111.51$145.431.5×
wellpath24$159.04$938.67$1,805.7611.4×
emblemhealth13$242.83$1,054$1,6226.7×
centers plan for healthy living23$138.76$990.36$1,109.478.0×
pennsylvania health and wellness13$165.29$187.83$4292.6×
vns12$990.36$1,725.41$2,460.452.5×
Medicare Advantage12$929.52$954.27$979.011.1×
metroplus12$135.11$602.18$1,069.257.9×
urn12$1,017.9$1,092.93$1,167.951.1×
capital district physicians health plan (cdphp) 514912$296.58$502.26$707.942.4×
Anthem BCBS12$117.95$117.95$117.951.0×
american health plans12$124.91$617.19$1,109.478.9×
jefferson health plans12$191.59$314.59$437.582.3×
6 degrees health12$1,044$1,180$1,3161.3×
life pittsburgh12$113.55$611.51$1,109.479.8×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
CHAMPLAIN VALLEY PHYSICIANS HOSPITALPLATTSBURGHNY16$4,016$4,016$96.56$604.97$5,440.01
ELIZABETHTOWN COMMUNITY HOSPITALELIZABETHTOWNNY16$3,168$3,168$96.56$598.19$2,917.73
ALICE HYDE MEDICAL CENTERMALONENY12$2,205$2,205$96.56$429.26$9,020.04
WESTFIELD MEMORIAL HOSPITALWESTFIELDNY15$341$75.02$98.89$237.27$2,130.18
FREDRICK FERRIS THOMPSON HOSPITALCANANDAIGUANY13$3,051$1,526$67.2$235.71$3,137.37
STONY BROOK UNIVERSITY HOSPITALSTONY BROOKNY16$2,196.99$2,196.99$467.37$2,102.83$5,108
ST. JOSEPHS MEDICAL CENTERYONKERSNY15$4,565$990.36$990.36$1,451.45$5,536.01
NASSAU UNIVERSITY MEDICAL CENTEREAST MEADOWNY11$1,119$783.3$117.95$1,073.38$3,079
MEMORIAL HOSPITAL FOR CANCER AND ALLNEW YORKNY18$2,527$2,527$80.8$1,009.36$10,588
NYU LANGONE HOSPITALSNEW YORKNY0$3,344.09$635.38
EASTERN LONG ISLAND HOSPITALGREENPORTNY0$3,344.09$635.38

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.