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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in CA

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Hospitals
35
Min
$469.92
Median
$1,235.50
Max
$6,729.00
Range multiplier
14.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield32116$235.98$3,288.64$10,81045.8×
Anthem BCBS28108$235.98$1,338.09$10,96546.5×
UnitedHealthcare2580$1.00$4,359.50$252,199252199.0×
Medicaid2271$332.55$593.05$2,025.106.1×
Aetna2959$235.98$2,813.30$23,44499.3×
Medicare2844$235.98$1,093.12$3,541.1015.0×
Kaiser Permanente2740$235.98$1,007.51$2,009.508.5×
Cigna2037$436.36$4,340.00$10,55324.2×
Health Net1337$11.43$1,632.10$5,632.00492.7×
Humana2326$235.98$1,093.12$5,786.0024.5×
Molina918$335.91$1,160.81$8,190.0024.4×
Empire BCBS28$487.07$1,160.81$1,451.013.0×
brand new day48$1,172.42$1,456.82$1,741.221.5×
TRICARE47$1,160.81$1,160.81$1,160.811.0×
ucsd [807]16$2,057.14$2,150.65$2,225.971.1×
emanate health26$1,160.81$1,160.81$2,321.622.0×
citrus valley physicians group26$1,160.81$1,160.81$1,160.811.0×
commercial | hill physicians | all plans55$1,142.58$1,142.58$1,142.581.0×
First Health55$943.92$1,483.32$5,435.005.8×
Bright Health44$882.00$1,135.10$1,249.531.4×
traditional medi-cal44$335.91$335.91$335.911.0×
vantage care24$335.91$748.36$1,160.813.5×
uh [819]13$441.56$649.35$2,207.795.0×
community health group13$1,366.46$1,929.12$2,692.732.0×
hn [815]13$462.34$641.56$2,103.894.6×
employer direct healthcare33$1,625.13$1,625.13$1,625.131.0×
veba med grp [813]13$524.67$654.54$2,225.974.2×
central health plan33$1,160.81$1,160.81$1,160.811.0×
imperial health plan of ca33$1,230.46$1,230.46$1,230.461.0×
commercial | connected care intel | all plans33$5,786.00$9,384.00$9,384.001.6×
renal payer solutions33$1,160.81$1,160.81$1,160.811.0×
naphcare23$1,799.26$1,799.26$1,799.261.0×
Multiplan33$1,005.48$1,125.32$2,813.302.8×
commercial | mhn | all plans33$1,033.55$1,235.50$1,235.501.2×
workers compensation22$1,529.19$1,529.19$1,529.191.0×
alignment22$1,160.81$1,160.81$1,160.811.0×
california health and wellness22$2,564.12$2,829.38$3,094.631.2×
caloptima22$335.91$335.91$335.911.0×
care 1st health plan12$840.00$840.00$840.001.0×
choice physicians network22$1,160.81$1,160.81$1,160.811.0×
commercial | epic health | all plans22$1,348.05$1,348.05$1,348.051.0×
commercial | la care | all plans22$1,160.83$1,199.06$1,237.281.1×
commercial | naphcare | all plans22$1,873.97$1,880.16$1,886.351.0×
commercial | sutter health | all plans22$3,832.94$3,864.08$3,895.221.0×
commercial | valley care ipa | all plans22$991.00$991.00$991.001.0×
epic health plan22$1,160.81$1,160.81$1,160.811.0×
interplan22$1.10$1,809.10$3,617.103288.3×
neighborhood22$1,184.03$1,184.03$1,184.031.0×
prime healthcare services12$1,160.81$1,160.81$1,160.811.0×
rios22$1,102.77$1,102.77$1,102.771.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Bernardine Medical CenterSan BernardinoCA11$423.61$999.00$19,284
St Elizabeth Community HosptialRed BluffCA7$466.91$983.94$1,343.63
Mercy Medical Center MercedMercedCA9$357.41$982.43$12,552
St. Mary Medical CenterApple ValleyCA11$337.55$968.65$7,322.00
Community Hospital Of San BernardinoSan BernardinoCA13$423.61$961.95$9,063.00
Pacifica Hospital Of The ValleySun ValleyCA13$8,190.00$8,190.00$672.00$861.00$8,190.00
Mark Twain Medical CenterSan AndreasCA12$1,026.00$718.20$235.98$729.95$1,005.48
Dominican HospitalSanta CruzCA9$423.61$6,729.00$23,444
Mercy Medical Center Mt. ShastaMt. ShastaCA7$406.45$469.92$1,343.63
Methodist Hospital Of SacramentoSacramentoCA11$423.61$4,530.00$11,836
Mercy Hospital Of FolsomFolsomCA10$423.61$3,918.00$10,296
Woodland HealthcareWoodlandCA7$423.61$3,640.91$7,034.00
Marian Medical CenterSanta MariaCA10$423.61$3,137.00$9,264.00
Mercy San Juan Medical CenterCarmichaelCA11$423.61$2,878.00$252,199
Central Valley Specialty HospitalModestoCA6$3,801.39$3,801.39$950.35$2,851.04$3,231.18
Sharp Memorial HospitalSan DiegoCA10$4,019.00$3,014.25$1.00$2,813.30$3,617.10
Glendale Memorial Hospital & Hlth CtGlendaleCA6$386.30$2,655.32$7,244.00
St. Johns Regional Medical CenterOxnardCA11$512.57$2,641.05$16,750
Grossmont HospitalLa MesaCA10$4,019.00$3,014.25$602.85$2,612.36$3,617.10
Sharp Chula Vista Medical CenterChula VistaCA15$4,019.00$3,014.25$11.43$2,451.59$4,117.35
St. Johns Pleasant Valley HospitalCamarilloCA11$423.61$2,025.10$16,750
Mercy General HospitalSacramentoCA11$423.61$1,703.91$18,443
Scripps Mercy HospitalSan DiegoCA13$2,597.40$649.35$436.36$1,677.92$2,316.88
Saint Francis Memorial HospitalSan FranciscoCA15$413.01$1,459.18$9,384.00
Sequoia HospitalRedwood CityCA12$423.61$1,244.53$10,333
St. Marys Medical CenterSan FranciscoCA13$416.53$1,235.50$9,384.00
Huntington Beach HospitalHuntington BeachCA16$5,669.74$1,160.00$335.91$1,160.81$1,741.22
Montclair Hospital Medical CenterMontclairCA24$10,819$1,160.00$335.91$1,160.81$2,321.62
Chino Valley Medical CenterChinoCA25$6,026.29$1,160.00$335.91$1,160.81$2,321.62
Garden Grove Hospital Medical CenterGarden GroveCA19$6,016.31$1,160.00$335.91$1,160.81$1,799.26
Sierra Nevada Memorial HospitalGrass ValleyCA9$423.61$1,142.58$11,058
St. Josephs Medical CenterStocktonCA2$1,081.30$1,081.30$1,081.30
St. Josephs Behavioral Hlth CenterStocktonCA2$1,081.30$1,081.30$1,081.30
Bakersfield Memorial HospitalBakersfieldCA11$423.61$1,037.66$9,954.00
Northridge Medical Center - RoscoeNorthridgeCA12$403.10$1,033.55$11,879

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.