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Upper GI endoscopy diagnostic

CPT 43235 · negotiated-rate distribution across hospitals in WI

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Hospitals
35
Min
$893.68
Median
$1,238.64
Max
$6,159.00
Range multiplier
6.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2373$110.43$2,976.00$8,190.0074.2×
Anthem BCBS2061$110.43$1,979.00$6,159.0055.8×
wisconsin physician service1236$2,883.00$3,035.00$3,035.001.1×
common ground1236$2,450.00$2,727.00$2,727.001.1×
Medicare1432$133.19$910.39$1,401.0010.5×
Molina1823$891.71$2,568.00$2,568.002.9×
VA Health1122$901.33$910.39$952.751.1×
Cigna1316$170.52$3,500.00$3,500.0020.5×
smart health714$1,274.55$1,274.55$1,333.851.0×
aspirus113$110.43$533.05$2,656.0924.1×
Humana613$115.95$1,112.21$1,112.219.6×
trilogy1212$4,387.00$4,387.00$4,387.001.0×
Aetna1212$1,894.00$1,894.00$1,894.001.0×
aurora caregiver1212$2,450.00$2,450.00$2,450.001.0×
Blue Cross Blue Shield412$135.14$1,135.20$3,937.0029.1×
centivo1212$3,169.00$3,169.00$3,169.001.0×
hs technology1212$3,152.00$3,152.00$3,152.001.0×
everpointe elite1212$2,153.00$2,153.00$2,153.001.0×
quartz one1212$2,790.00$2,790.00$2,790.001.0×
quartz group1212$3,260.00$3,260.00$3,260.001.0×
health payment systems1212$3,350.00$3,350.00$3,350.001.0×
wps77$1,127.06$1,127.06$1,127.061.0×
network health plan57$193.51$891.71$4,326.4122.4×
prevea 36017$110.43$905.61$3,762.8034.1×
Medicaid26$143.36$1,096.95$2,395.6016.7×
security health plan26$182.70$674.31$1,372.317.5×
mercy care15$213.15$533.05$1,469.706.9×
medica [900156]35$907.29$1,032.61$3,340.713.7×
First Health35$914.40$1,038.94$3,366.903.7×
smarthealth24$1,261.86$1,261.86$1,261.861.0×
WellCare24$946.40$946.40$946.401.0×
ma wisconsin replacement [950271]23$1,257.00$1,267.00$3,090.002.5×
alliance33$1,093.82$1,093.82$1,093.821.0×
healthpartners [900713]33$1,730.78$2,326.73$2,673.811.5×
illinicare12$110.43$508.02$905.618.2×
medical associates health plan12$366.63$980.15$1,593.664.3×
health partners open network12$253.88$934.84$1,615.796.4×
meridiancare12$115.95$510.78$905.617.8×
quartz22$893.68$1,137.43$1,381.171.5×
centivo nw322$1,017.26$1,017.26$1,017.261.0×
unitedhealth group of wi12$893.68$2,809.84$4,726.005.3×
centivo nw122$1,017.26$1,017.26$1,017.261.0×
cchp22$673.55$673.55$673.551.0×
icare22$891.71$923.98$956.241.1×
veteran's administration (va ccn)11$893.68$893.68$893.681.0×
health partners11$891.71$891.71$891.711.0×
group health cooperative of eau claire11$947.30$947.30$947.301.0×
security health plan (shp)11$893.68$893.68$893.681.0×
community care incorporated11$891.71$891.71$891.711.0×
allwell11$909.55$909.55$909.551.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Wheaton Franciscan Healthcare - AllRacineWI4$952.75$952.75$1,333.85
All Saints - St. Luke S HospitalRacineWI4$952.75$952.75$1,333.85
MoshFranklinWI4$910.39$910.39$1,274.55
Wheaton Franciscan - FranklinFranklinWI4$910.39$910.39$1,274.55
Wfhc - Elmbrook MemorialBrookfieldWI4$910.39$910.39$1,274.55
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI4$910.39$910.39$1,274.55
Ascension Se Wisconsin Hospital IncMilwaukeeWI4$910.39$910.39$1,274.55
Meriter Hospital Inc.MadisonWI14$4,426.82$3,541.46$110.43$905.61$5,169.00
Ascension Ne Wisconsin-St. ElizabethAppletonWI9$2,787.00$1,588.59$126.80$901.33$1,892.79
Mercy Medical CenterOshkoshWI9$2,787.00$1,588.59$126.80$901.33$1,892.79
Holy Family Memorial IncManitowocWI10$891.71$900.63$6,312.00
Beaver Dam Community HospitalsBeaver DamWI11$893.68$893.68$5,571.00
Childrens Hospital Of Wi-Fox ValleyNeenahWI2$5,749.00$6,159.00$8,190.00
Ssh - Fox ValleyOshkoshWI2$5,749.00$6,159.00$8,190.00
Childrens WisconsinMilwaukeeWI2$5,749.00$6,159.00$8,190.00
Aurora Medical Center - Bay AreaMarinetteWI15$1,894.00$2,965.50$5,100.00
Memorial Hospital Of BurlingtonBurlingtonWI15$1,894.00$2,955.00$4,387.00
Aurora Health Care Metro Inc.MilwaukeeWI15$1,894.00$2,955.00$4,387.00
West Allis Memorial HospitalWest AllisWI15$1,894.00$2,955.00$4,387.00
Aurora Medical Center KenoshaKenoshaWI15$1,894.00$2,955.00$4,387.00
Aurora Medical Center Of OshkoshOshkoshWI15$1,894.00$2,955.00$4,387.00
Aurora Medical Center - HartfordHartfordWI15$1,894.00$2,955.00$4,387.00
Sheboygan Memorial HospitalSheboyganWI15$1,894.00$2,955.00$4,387.00
Aurora Medical Center - SummitSummitWI15$1,894.00$2,955.00$4,387.00
Aurora Medical Center GraftonGraftonWI15$1,894.00$2,955.00$4,387.00
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI15$1,894.00$2,955.00$4,387.00
Aurora Lakeland Medical CenterElkhornWI15$1,894.00$2,955.00$4,387.00
Hudson HospitalHudsonWI8$3,090.00$1,393.90$1,013.52$1,433.95$3,912.00
Amery Regional Medical CenterAmeryWI6$3,741.00$1,950.56$133.19$1,238.64$3,627.27
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$4,122.00$2,184.66$193.51$1,112.21$1,112.21
Ascension Columbia St Marys OzaukeeMequonWI7$4,122.00$2,184.66$193.51$1,103.02$2,007.94
Ascension Columbia St Marys MilwaukeMilwaukeeWI7$193.51$1,103.02$2,007.94
Westfields HospitalNew RichmondWI8$1,267.00$666.44$133.19$1,024.46$2,395.60
Uw Health Rehabilitation HospitalMadisonWI0$3,255.00$1,953.00
University Of Wi Hospitals & ClinicsMadisonWI0$3,255.00$1,953.00

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.