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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in MA

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Hospitals
9
Min
$1,003.17
Median
$1,141.32
Max
$1,155.45
Range multiplier
1.2×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare659$22.71$1,177.46$4,584.00201.8×
Blue Cross Blue Shield658$52.12$870.88$3,455.0066.3×
Medicaid444$2.89$83.37$2,328.18805.6×
institution [10406]440$7.59$1,465.79$3,455.00455.2×
correctional care [11003]326$1,086.97$1,100.43$4,770.984.4×
harvard pilgrim [10701]424$745.36$761.55$761.551.0×
Cigna622$701.92$1,830.50$4,770.986.8×
Aetna619$24.88$2,252.66$5,758.48231.5×
tufts connectorcare [10507]414$1,848.94$1,871.83$3,960.232.1×
mgb mcr [10124]414$1,100.43$1,155.45$2,444.582.2×
senior whole health [10110]412$1,163.06$1,177.46$2,491.152.1×
CHAMPVA412$1,002.07$1,192.46$2,412.742.4×
tufts us family [11203]412$1,086.97$1,100.43$2,328.182.1×
tufts [11201]412$701.92$2,158.43$2,374.303.4×
tufts mcr supp [20209]212$570.66$1,141.32$2,414.704.2×
commonwealth care mcr [10115]311$1,141.32$1,155.45$2,444.582.1×
tufts dual [10111]311$1,086.97$1,100.43$2,328.182.1×
Medicare311$1,086.97$1,100.43$2,328.182.1×
fallon mcr [10105]311$1,141.32$1,155.45$2,444.582.1×
eternalhealth mcr replace [10116]28$1,141.32$1,148.39$2,414.702.1×
harvard pilgrim mcr supp [20203]28$1,141.32$1,148.39$2,414.702.1×
wellpoint [11112]48$1,508.22$1,508.22$1,508.221.0×
hsno/free care [10801]48$294.30$672.16$680.812.3×
workers compensation [20501]47$379.98$963.41$1,382.003.6×
fallon connectorcare [10503]47$506.00$506.00$2,736.945.4×
grants [20507]46$6.52$2,715.00$3,805.00583.6×
fallon mcr supp [20202]26$1,155.45$1,155.45$2,444.582.1×
tufts mcr [10112]26$1,155.45$1,155.45$2,444.582.1×
First Health55$60.00$2,591.25$2,853.7547.6×
connecticare [11105]44$1,975.00$3,455.00$3,805.001.9×
hne [11108]44$1,285.33$1,558.21$2,122.811.7×
fallon mcaid carelon hlth [29]44$1,975.00$3,455.00$3,805.001.9×
geisinger13$969.07$2,050.00$3,555.073.7×
masshealth mcd mbhp [38]33$1,975.00$3,455.00$3,455.001.7×
Multiplan33$2,591.25$2,591.25$2,853.751.1×
pennsylvania health and wellness13$978.39$1,000.00$1,723.831.8×
evernorth behavioral health [27]33$1,580.00$2,764.00$2,764.001.7×
commonwealth care alliance [10103]13$1,155.45$1,155.45$2,444.582.1×
upmc health plan13$208.01$297.16$978.394.7×
harvard pilgrim mcr [10106]13$1,155.45$1,155.45$2,444.582.1×
fidelis care12$25.96$538.92$1,051.8740.5×
fallon carelon hlth [28]22$1,975.00$2,890.00$3,805.001.9×
wellfleet [11106]22$3,109.50$3,109.50$3,109.501.0×
optum transplant [20601]22$3,455.00$3,455.00$3,455.001.0×
wellpoint12$1,051.87$2,158.94$3,266.003.1×
qualcare inc12$87.00$1,852.00$3,617.0041.6×
automobile [10401]22$3,455.00$3,455.00$3,455.001.0×
devon health12$6,201.44$6,201.44$6,201.441.0×
amerihealth12$37.03$41.97$46.911.3×
health partners plans12$978.39$1,096.20$1,214.001.2×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Harrington Memorial HospitalSouthbridgeMA31$9,769.19$9,769.19$55.91$1,155.45$3,960.23
Healthalliance-ClintonLeominsterMA32$14,790$14,790$55.58$1,155.45$4,409.20
Marlborough HospitalMarlboroughMA38$17,413$17,413$2.89$1,141.32$4,770.98
Umass Memorial Medical CenterWorcesterMA38$17,413$17,413$2.89$1,141.32$4,770.98
Beth Israel Deaconess - PlymouthPlymouthMA13$4,881.00$22.71$1,051.87$4,908.00
Chestnut Hill Benevolent AssociationChestnut HillMA19$6,328.00$208.01$1,003.17$6,201.44
North Adams Regional HospitalNorth AdamsMA0$2,655.78$2,522.99
Fairview HospitalGreat BarringtonMA0$2,655.78$2,522.99
Berkshire Medical CenterPittsfieldMA0$2,655.78$2,522.99

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.