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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in GA

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Hospitals
8
Min
$299.25
Median
$906.76
Max
$2,051
Range multiplier
6.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna619$256.5$999.27$11,58445.2×
UnitedHealthcare618$1$848.09$3,2503250.0×
Blue Cross Blue Shield416$58.84$1,758.28$4,043.9168.7×
Cigna413$1$1,424.04$4,9174917.0×
Humana612$143.76$825.46$4,11328.6×
WellCare510$285$941.1$1,049.243.7×
First Health38$270.75$2,517.5$4,313.2415.9×
CareSource37$13.49$932.42$1,584.21117.5×
Health Net16$143.76$642.14$2,570.517.9×
Medicaid14$1$218.19$844.14844.1×
Ambetter34$1,040.54$1,296.68$1,552.821.5×
banner health13$143.76$285$999.277.0×
Oscar Health23$1,176.84$1,505.76$1,505.761.3×
peach state13$12.84$932.42$1,086.3184.6×
devoted health23$302.1$932.42$1,059.233.5×
arizona medical network12$285$642.14$999.273.5×
alliant op rate22$2,051$2,051$2,0511.0×
blue mcr replacement12$941.1$941.1$941.11.0×
bridgeway health solutions12$285$642.14$999.273.5×
dodge cty op rate22$1,129.3$1,139.75$1,150.21.0×
facility billing - op12$941.1$941.1$941.11.0×
health choice pathway12$285$642.14$999.273.5×
health management network12$285$642.14$999.273.5×
healthspring mcr replacement12$950.51$955.22$959.921.0×
imperial insurance12$299.25$674.25$1,049.243.5×
Medicare Advantage12$941.1$941.1$941.11.0×
occunet12$1,741.04$1,929.26$2,117.471.2×
riverwood behavioral health12$905.26$1,018.42$1,131.581.3×
rural arizona network12$285$642.14$999.273.5×
secure health op rate22$2,260$2,260$2,2601.0×
smarthealth12$1,317.54$1,317.54$1,317.541.0×
sonder health plan12$950.52$950.52$950.521.0×
united mine workers of america12$285$642.14$999.273.5×
Medicare11$905.26$905.26$905.261.0×
TRICARE11$905.26$905.26$905.261.0×
mercy care11$150.95$150.95$150.951.0×
Multiplan11$905.26$905.26$905.261.0×
naphcare11$1,403.15$1,403.15$1,403.151.0×
novanet11$905.26$905.26$905.261.0×
americas choice provider network11$905.26$905.26$905.261.0×
acchs11$143.76$143.76$143.761.0×
arizona complete health11$143.76$143.76$143.761.0×
corvel11$905.26$905.26$905.261.0×
peach state hp op rate11$1,031.02$1,031.02$1,031.021.0×
employer direct healthcare11$1,267.36$1,267.36$1,267.361.0×
phcs op rate11$4,409.09$4,409.09$4,409.091.0×
clear spring health plan11$905.26$905.26$905.261.0×
georgia workers’ compensation11$905.26$905.26$905.261.0×
health choice11$150.95$150.95$150.951.0×
prime health services11$905.26$905.26$905.261.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ST. MARYS SACRED HEART HOSPITALLAVONIAGA12$941.1$969.33$11,584
PERRY HOSPITALPERRYGA10$1,672.3$743.25$906.76$3,768
SOUTHERN REGIONAL MEDICAL CENTERRIVERDALEGA26$4,131.95$905$12.84$905.26$2,297.2
DODGE COUNTY HOSPITALEASTMANGA6$1,582.27$1$790.92$1,700
WEST CENTRAL GA REGIONAL HOSPITALCOLUMBUSGA22$2,650$1,966.3$143.76$299.25$2,570.5
HOUSTON MEDICAL CENTERWARNER ROBINSGA16$1,672.3$743.25$2,051$4,917
SOUTHWELL MEDICALADELGA0
UNION GENERAL HOSPITALBLAIRSVILLEGA0

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.