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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in MI

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Hospitals
28
Min
$191.19
Median
$969.33
Max
$1,852.97
Range multiplier
9.7×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Medicare1385$121.55$865.08$1,463.0112.0×
Medicaid1381$87.33$512.85$3,268.3037.4×
UnitedHealthcare2177$87.33$899.68$3,319.0038.0×
Aetna2264$158.31$1,001.09$11,58473.2×
Humana1941$121.55$914.38$1,075.068.8×
Blue Cross Blue Shield1540$218.37$791.79$3,268.3015.0×
priority health op rate1018$228.83$1,275.75$3,851.7616.8×
smarthealth816$1,317.54$1,317.54$1,368.261.0×
Ambetter816$1,552.82$1,552.82$1,583.271.0×
Medicare Advantage916$798.67$941.10$941.101.2×
facility billing - op714$941.10$941.10$941.101.0×
WellCare714$941.10$941.10$941.101.0×
Oscar Health714$1,505.76$1,505.76$1,505.761.0×
occunet714$1,741.04$1,929.26$2,117.471.2×
blue mcr replacement714$941.10$941.10$941.101.0×
healthspring mcr replacement714$950.51$955.22$959.921.0×
hap preferred op rate411$243.24$1,022.96$4,094.3116.8×
TRICARE1011$826.74$899.68$1,977.272.4×
priority health910$40.00$207.95$482.2512.1×
First Health810$200.81$1,888.41$3,838.7119.1×
mclaren health op rate49$142.44$571.81$2,397.6916.8×
u of m health plan88$139.78$139.78$139.781.0×
hap - hmo op rate58$765.03$1,392.73$2,086.452.7×
mclaren commercial ins88$276.56$276.56$276.561.0×
hap - hmo88$131.84$131.84$131.841.0×
mi amish medical board77$914.38$914.38$914.381.0×
hap ahl op rate27$243.24$887.78$4,094.3116.8×
hap hmo op rate27$224.01$877.99$3,770.6916.8×
cofinity - auto op rate47$1,177.36$1,709.24$2,200.861.9×
health plus hmo op rate27$269.01$969.92$4,528.1316.8×
Cigna27$225.74$949.39$3,799.8316.8×
hp - ppo op rate46$1,182.55$1,799.83$2,571.032.2×
hp - hmo op rate46$888.63$1,351.81$1,852.972.1×
detroit medical center op rate16$138.83$509.84$2,336.8916.8×
cofinity ppom op rate16$296.10$1,087.39$4,984.1116.8×
cofinity - ppom op rate35$1,017.83$1,477.64$3,861.293.8×
mhp - hmo op rate24$667.40$860.72$968.911.5×
harbor health plan14$482.25$530.48$899.681.9×
health advantage - ppo op rate24$667.40$860.72$968.911.5×
bsbs bcn op rate14$376.24$758.82$1,079.622.9×
hap/ahl op rate13$765.03$871.43$1,110.651.5×
hcap op rate33$1,310.70$2,709.68$2,709.682.1×
cofinity wc op rate13$1,017.83$1,159.39$1,477.641.5×
total health care priority health13$482.25$885.55$899.681.9×
mclaren health advantage op rate23$836.58$1,455.64$1,495.211.8×
hurley medical center op rate13$581.62$662.51$844.371.5×
hap - ppo op rate33$1,882.87$2,894.84$2,894.841.5×
cofinity - wc/auto op rate13$1,177.36$1,341.11$1,709.241.5×
Multiplan22$1,403.67$1,623.44$1,843.201.3×
cofinity op rate22$1,291.35$1,320.69$1,350.021.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Genesys Regional Medical Ctr.Grand BlancMI12$941.10$969.33$11,584
Borgess-Pipp Health CenterPlainwellMI12$941.10$969.33$11,584
Ascension Allegan HospitalAlleganMI12$941.10$969.33$11,584
Ascension Borgess-Lee HospitalDowagiacMI12$941.10$969.33$11,584
Ascension Borgess HospitalKalamazooMI12$941.10$969.33$11,584
Ascension Standish HospitalStandishMI12$941.10$969.33$11,584
Ascension Providence Rochester HospiRochesterMI12$941.10$969.33$11,584
Mclaren FlintFlintMI26$6,308.72$3,154.36$87.33$914.38$2,563.26
Mclaren Lapeer RegionLapeerMI24$7,454.41$3,727.21$87.33$912.30$3,268.30
Garden City Hospital OsteopathicGarden CityMI19$7,529.17$899.00$40.00$899.68$1,394.50
Karmanos Cancer HospitalDetroitMI15$3,166.52$138.83$765.67$4,984.11
Mclaren Port HuronPort HuronMI29$5,447.20$2,723.60$87.33$649.56$1,747.60
Bay Regional Medical CenterBay CityMI24$4,467.61$2,258.07$87.33$624.84$3,861.29
Mclaren Central MichiganMt PleasantMI17$6,469.76$3,234.88$87.33$520.54$1,549.62
Mclaren Northern MichiganPetoskeyMI15$3,946.39$1,973.20$87.33$512.85$1,463.01
Mclaren Greater LansingLansingMI20$6,639.51$3,319.76$87.33$512.85$1,463.01
Ascension St John HospitalDetroitMI3$158.31$370.51$370.51
Mclaren Thumb RegionBad AxeMI11$5,564.63$2,782.32$87.33$191.19$1,977.27
Mclaren Bay Special CareBay CityMI17$2,258.07$410.95$1,852.97$3,861.29
Mclaren OaklandPontiacMI14$1,417.53$481.71$1,847.84$2,835.06
Mclaren MacombMt. ClemensMI20$1,246.00$135.00$1,355.90$2,073.60
Tawas St. Joseph HospitalTawasMI9$3,966.00$1,308.78$977.33$1,050.63$1,864.02
North Ottawa Community HospitalGrand HavenMI0$8,561.99$5,993.39
Sparrow Clinton HospitalSt. JohnsMI0$735.00$367.50
Sparrow EatonCharlotteMI0$735.00$367.50
Mackinac Straits Health System IncSt. IgnaceMI0$551.00$385.70
Carson City HospitalCarson CityMI0$735.00$367.50
Mckenzie Health SystemSanduskyMI0$2,239.00$1,791.20

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.