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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in SD

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Hospitals
2
Min
$2,201.04
Median
$5,677.00
Max
$5,677.00
Range multiplier
2.6×

By payer (32 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
TRICARE19$926.00$926.00$926.001.0×
Blue Cross Blue Shield28$926.00$2,672.00$5,677.006.1×
UnitedHealthcare26$926.00$2,201.04$5,677.006.1×
medica (commercial) 94265 [3081118]13$3,296.53$3,296.53$3,296.531.0×
Humana23$926.00$3,574.55$5,677.006.1×
healthpartners [3081368]13$926.00$926.00$926.001.0×
govt employees health assn [3081090]13$2,201.04$2,201.04$2,201.041.0×
Cigna13$3,812.86$3,812.86$3,812.861.0×
Aetna13$3,574.55$3,574.55$3,574.551.0×
Meritain Health12$3,812.86$3,812.86$3,812.861.0×
Medicare22$926.00$3,301.50$5,677.006.1×
national telephone cooperative assn 52103 [3081149]12$2,201.04$2,201.04$2,201.041.0×
risk admin svs [3081167]12$1,170.20$1,170.20$1,170.201.0×
key benefit administrators [3081332]11$3,812.86$3,812.86$3,812.861.0×
employee benefit management 12x44 [3081079]11$3,375.96$3,375.96$3,375.961.0×
allied benefit systems inc [3081320]11$3,812.86$3,812.86$3,812.861.0×
coresource 38225 [3081146]11$2,581.62$2,581.62$2,581.621.0×
midlands choice 47080 [3081136]11$3,812.86$3,812.86$3,812.861.0×
minnesota health care programs 12k16 [3081295]11$1,203.43$1,203.43$1,203.431.0×
Multiplan11$2,830.36$2,830.36$2,830.361.0×
va black hills health care system 12115 [3081206]11$926.00$926.00$926.001.0×
pacificsource health plans [3081333]11$3,375.96$3,375.96$3,375.961.0×
preferred one 41147 [3081160]11$3,812.86$3,812.86$3,812.861.0×
va ccn optum [3081339]11$926.00$926.00$926.001.0×
rocky mountain admin llc 83028 [3081168]11$3,177.37$3,177.37$3,177.371.0×
sanford health plan 91184 [3081174]11$3,574.55$3,574.55$3,574.551.0×
surest [3081369]11$2,201.04$2,201.04$2,201.041.0×
tlc advantage llc [3081189]11$3,733.42$3,733.42$3,733.421.0×
avera health plans 46045 [3081018]11$2,919.22$2,919.22$2,919.221.0×
health partners sx009 [3081102]11$1,956.45$1,956.45$1,956.451.0×
group and pension administrators inc [3081098]11$2,830.36$2,830.36$2,830.361.0×
fedmed inc [3081283]11$3,773.14$3,773.14$3,773.141.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Monument Health Spearfish HospitalSpearfishSD4$6,189.83$5,792.02$2,665.00$5,677.00$5,677.00
Monument Health Rapid City HospitalRapid CitySD32$3,971.72$3,971.72$926.00$2,201.04$3,812.86

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.