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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in PA

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Hospitals
57
Min
$263.62
Median
$1,074.06
Max
$3,910.09
Range multiplier
14.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield35228$139.62$1,063.17$6,300.0045.1×
Aetna35197$125.22$1,444.76$6,316.0050.4×
upmc health plan33117$137.74$911.55$2,562.3718.6×
Cigna33103$430.42$1,315.60$5,460.0012.7×
UnitedHealthcare31103$131.48$958.35$6,368.0048.4×
pa health & wellness2553$213.40$442.71$2,315.5210.9×
amerihealth caritas3052$137.74$195.48$2,208.3216.0×
Multiplan1150$701.96$4,584.06$5,583.158.0×
intergroup1544$1,171.20$3,080.80$5,289.304.5×
geisinger2442$137.74$188.67$3,937.5928.6×
First Health1334$1,416.80$2,944.38$3,955.222.8×
Humana1829$414.02$1,821.60$4,584.0511.1×
upmc work partners2727$615.84$635.45$663.701.1×
private health care systems1326$444.00$2,234.40$4,314.409.7×
health partners plans (jefferson health plan)1717$170.55$188.83$188.831.1×
keystone first413$201.38$797.94$2,634.1613.1×
wirerope works512$2,963.48$3,267.61$3,267.611.1×
america's choice512$4,701.60$4,701.60$5,289.301.1×
preferred healthcare system612$1,396.50$1,396.50$3,505.452.5×
pennsylvania health and wellness39$279.55$1,048.65$2,834.4910.1×
health partners plans39$950.44$1,670.00$1,670.001.8×
three rivers provider network48$679.79$2,984.55$5,289.307.8×
selectcare48$1,821.60$3,182.40$4,314.402.4×
Medicaid28$137.74$224.58$386.932.8×
health coalition partners46$1,821.60$2,027.27$4,314.402.4×
ibc26$1,575.00$1,730.94$1,913.641.2×
health plan of upper ohio valley35$893.85$911.73$1,459.461.6×
gateway health plan35$150.26$820.51$1,191.657.9×
keystone autism services44$1,433.04$1,436.74$1,440.781.0×
national provider network24$2,746.48$3,408.48$4,070.481.5×
health payors organization24$4,467.60$4,525.83$4,584.051.0×
univera13$577.65$1,270.83$1,694.442.9×
fidelis23$1,031.62$4,044.75$4,044.753.9×
keystone health plan33$2,200.80$2,200.80$2,581.951.2×
prime health services33$1,483.24$1,517.49$1,517.491.0×
Medicare13$125.49$140.95$167.351.3×
elder health33$1,118.16$1,143.98$1,143.981.0×
clover health33$987.71$1,010.52$1,010.521.0×
occunet33$1,206.70$1,572.98$1,572.981.3×
Oscar Health33$1,397.70$1,429.98$1,429.981.0×
innovage33$972.39$972.39$1,127.481.2×
jup geisinger commercial13$225.87$253.10$297.951.3×
Anthem BCBS13$528.00$1,064.26$1,423.182.7×
naphcare22$1,429.98$1,429.98$1,429.981.0×
city of washington22$1,787.70$1,787.70$1,787.701.0×
community care behavioral health12$411.40$617.10$822.802.0×
galaxy health plan12$1,171.20$1,171.20$1,171.201.0×
independent health12$1,300.05$1,356.29$1,412.521.1×
jup health partners chip12$232.00$247.81$263.621.1×
pa health_wellness chc12$162.79$267.29$371.802.3×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Upmc Pinnacle HospitalsHarrisburgPA12$169.05$977.60$2,249.82
Community General Osteopathic Hosp.HarrisburgPA12$169.05$977.60$2,249.82
Altoona Regional Health SystemAltoonaPA12$2,793.00$1,675.80$125.22$965.36$2,234.40
Upmc Childrens Hospital Of PghPittsburghPA12$2,793.00$1,675.80$125.22$965.36$2,234.40
Upmc Magee-Womens HospitalPittsburghPA12$2,793.00$1,675.80$125.22$965.36$2,234.40
The Childrens Home Of PittsburghPittsburghPA12$2,793.00$1,675.80$125.22$965.36$2,234.40
Upmc JamesonNew CastlePA13$3,121.00$1,872.60$137.74$949.32$2,746.48
Memorial HospitalYorkPA11$159.03$943.98$3,397.00
Upmc LititzLititzPA10$159.03$942.36$3,397.00
Upmc CarlisleCarlislePA12$159.03$916.18$3,397.00
Upmc HanoverHanoverPA12$159.03$914.91$3,397.00
The Washington HospitalWashingtonPA8$144.00$911.73$2,061.40
Whs - GreeneWaynesburgPA8$144.00$911.73$2,061.40
Curahealth Heritage ValleyBeaverPA9$1,379.08$372.35$125.22$798.57$1,379.08
WellsboroWellsboroPA14$5,877.00$4,264.00$137.74$3,910.09$5,583.15
Upmc ShadysidePittsburghPA20$5,393.00$3,235.80$137.74$3,505.45$4,584.05
Muncy Valley HospitalMuncyPA15$5,877.00$3,526.20$137.74$2,944.38$5,583.15
Williamsport Hospital & Medical CtrWilliamsportPA15$5,877.00$3,526.20$137.74$2,803.33$5,289.30
Lock Haven HospitalLock HavenPA15$5,877.00$3,526.20$137.74$2,803.33$5,289.30
Divine Providence HospitalWilliamsportPA15$5,877.00$3,526.20$137.74$2,803.33$5,289.30
Aria HealthPhiladelphiaPA12$3,942.00$1,023.55$125.49$263.62$3,362.00
Upmc Mercy HospitalPittsburghPA16$4,964.00$2,978.40$137.74$1,737.40$4,467.60
Upmc MckeesportMckeesportPA13$3,768.00$2,260.80$137.74$1,463.87$3,202.80
Upmc East HospitalMonroevillePA13$3,802.00$2,281.20$137.74$1,452.36$3,281.43
Upmc Northwest HospitalSenecaPA13$2,597.00$1,558.20$137.74$1,414.58$3,704.00
Thomas Jefferson Univ. HospitalPhiladelphiaPA8$2,601.00$1,071.57$162.79$1,342.41$6,300.00
Upmc Bedford Memorial HospitalEverettPA17$2,024.00$1,214.40$131.48$1,254.88$1,861.98
Upmc Horizon HospitalGreenvillePA17$3,121.00$1,872.60$137.74$1,217.19$2,652.85
Upmc St MargaretPittsburghPA12$4,188.00$2,512.80$137.74$1,214.52$3,559.80
Upmc HamotEriePA16$3,851.00$2,310.60$137.74$1,155.30$3,080.80
American Oncologic HospialPhiladelphiaPA16$3,937.00$201.38$1,127.48$6,316.00
Temple University HospitalPhiladelphiaPA20$3,937.00$175.31$1,122.19$6,368.00
Upmc PassavantPittsburghPA14$3,159.00$1,895.40$137.74$1,074.06$3,281.43
Jeanes HospitalPhiladelphiaPA18$3,937.00$236.10$1,048.65$4,300.00
Charles Cole Memorial HospitalCoudersportPA13$1,464.00$878.40$131.48$1,024.80$1,713.43
Pennsylvania Hospital Of UphsPhiladelphiaPA0$3,897.00$3,897.00
Milton S. Hershey Medical CenterHersheyPA0$6,094.00$2,018.94
Physicians Care Surgical HospitalRoyersfordPA0$5,696.00$10,218
Hampden Medical CenterEnolaPA0$6,094.00$1,917.78
Meyersdale Community HospitalMeyersdalePA0$2,801.82$1,120.73
Miners HospitalHastingsPA0$2,758.00$1,103.20
Reading Hospital And Medical CenterReadingPA0$2,813.00$1,969.10
Penn State Hershey Rehabilitation LlHummelstownPA0$6,094.00$1,585.05
Uniontown HospitalUniontownPA0$2,096.00$1,048.00
Hospital Of The Univ Of PennaPhiladelphiaPA0$3,897.00$3,897.00
Holy Spirit HospitalCamp HillPA0$6,094.00$1,455.86
Windber Hospital Inc.WindberPA0$483.00$410.55
Wayne Memorial HospitalHonesdalePA0$1,724.00$1,206.80
Miners HospitalHastingsPA0$2,758.00$1,103.20
Westmoreland Regional HospitalGreensburgPA0$1,900.00$1,140.00
St. Joseph Medical CenterReadingPA0$6,094.00$1,585.05
Butler Memorial HospitalButlerPA0
Doylestown HospitalDoylestownPA0$2,932.50$2,932.50
Clarion HospitalClarionPA0
Frick HospitalMount PleasantPA0$1,900.00$1,140.00
Latrobe Area HospitalLatrobePA0$1,900.00$1,140.00
Presbyterian Medical CenterPhiladelphiaPA0$4,027.00$4,027.00

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.