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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in PA

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Hospitals
59
Min
$300.39
Median
$1,146.11
Max
$4,691.70
Range multiplier
15.6×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield35219$165.67$1,325.98$6,300.0038.0×
Aetna35195$148.58$1,808.73$6,316.0042.5×
upmc health plan33115$163.44$911.73$2,876.0117.6×
Cigna33103$312.23$1,650.80$7,560.0024.2×
UnitedHealthcare31100$156.01$962.74$6,368.0040.8×
pa health & wellness2553$253.21$321.15$2,315.529.1×
amerihealth caritas3052$163.44$231.95$2,208.3213.5×
Multiplan1150$836.53$4,584.06$5,774.406.9×
intergroup1544$849.60$3,474.80$6,135.307.2×
geisinger2442$163.44$223.86$3,937.5924.1×
First Health1334$1,932.70$3,108.93$5,052.602.6×
Humana1829$300.33$1,757.60$6,135.3020.4×
upmc work partners2727$687.55$730.25$802.191.2×
private health care systems1326$596.00$2,843.20$5,774.409.7×
health partners plans (jefferson health plan)1717$202.37$224.06$224.061.1×
keystone first413$238.95$783.99$2,634.1611.0×
america's choice512$4,701.60$4,701.60$5,289.301.1×
preferred healthcare system612$1,396.50$1,396.50$4,691.703.4×
wirerope works512$2,963.48$3,267.61$3,267.611.1×
health partners plans39$950.44$1,670.00$1,670.001.8×
three rivers provider network48$810.12$3,049.71$5,289.306.5×
pennsylvania health and wellness38$331.70$1,036.82$2,834.498.5×
selectcare48$2,484.90$4,794.40$5,774.402.3×
Medicaid28$163.44$265.96$380.162.3×
health coalition partners46$2,484.90$2,723.89$5,774.402.3×
ibc26$1,575.00$1,959.00$3,508.342.2×
health plan of upper ohio valley35$893.85$911.73$1,704.781.9×
national provider network24$1,933.36$3,001.92$4,070.482.1×
gateway health plan34$178.30$1,006.08$1,191.656.7×
keystone autism services44$1,433.04$1,436.74$1,440.781.0×
health payors organization24$4,467.60$5,301.45$6,135.301.4×
elder health33$1,118.16$1,143.98$1,143.981.0×
keystone health plan33$2,200.80$2,200.80$2,581.951.2×
innovage33$972.39$972.39$1,127.481.2×
Medicare13$147.69$165.88$196.951.3×
clover health33$987.71$1,010.52$1,010.521.0×
Anthem BCBS13$699.00$1,407.31$1,881.912.7×
occunet33$1,206.70$1,572.98$1,572.981.3×
Oscar Health33$1,397.70$1,429.98$1,429.981.0×
prime health services33$1,483.24$1,517.49$1,517.491.0×
univera13$781.05$1,718.31$2,291.082.9×
jup geisinger commercial13$265.81$297.86$350.651.3×
fidelis23$1,031.62$5,413.50$5,413.505.2×
naphcare22$1,429.98$1,429.98$1,429.981.0×
city of washington22$1,787.70$1,787.70$1,787.701.0×
galaxy health plan12$849.60$849.60$849.601.0×
independent health12$1,300.05$1,356.29$1,412.521.1×
jup health partners chip12$299.96$300.18$300.391.0×
abington pro ibc12$144.92$162.69$180.471.2×
pa health_wellness chc12$193.15$279.23$365.301.9×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Upmc Pinnacle HospitalsHarrisburgPA12$200.58$977.60$3,485.00
Community General Osteopathic Hosp.HarrisburgPA12$200.58$977.60$3,485.00
Upmc Childrens Hospital Of PghPittsburghPA12$2,793.00$1,675.80$148.58$965.36$2,524.07
Altoona Regional Health SystemAltoonaPA12$2,793.00$1,675.80$148.58$965.36$2,524.07
Upmc Magee-Womens HospitalPittsburghPA12$2,793.00$1,675.80$148.58$965.36$2,524.07
The Childrens Home Of PittsburghPittsburghPA12$2,793.00$1,675.80$148.58$965.36$2,524.07
Upmc JamesonNew CastlePA13$2,197.00$1,318.20$163.44$959.26$2,316.50
Memorial HospitalYorkPA11$188.70$943.98$5,035.00
Upmc LititzLititzPA10$188.70$942.36$5,035.00
Upmc CarlisleCarlislePA12$188.70$916.18$5,035.00
Upmc HanoverHanoverPA12$188.70$914.91$5,035.00
Whs - GreeneWaynesburgPA8$170.87$911.73$2,061.40
The Washington HospitalWashingtonPA8$170.87$911.73$2,061.40
Curahealth Heritage ValleyBeaverPA9$1,325.98$358.01$148.58$878.10$1,325.98
Charles Cole Memorial HospitalCoudersportPA13$1,062.00$637.20$156.01$796.50$2,316.50
Upmc ShadysidePittsburghPA20$7,218.00$4,330.80$163.44$4,691.70$6,135.30
WellsboroWellsboroPA14$5,877.00$4,264.00$163.44$3,910.09$5,583.15
Aria HealthPhiladelphiaPA12$3,942.00$1,023.55$144.92$300.39$4,204.00
Muncy Valley HospitalMuncyPA15$5,877.00$3,526.20$163.44$2,944.38$5,583.15
Williamsport Hospital & Medical CtrWilliamsportPA15$5,877.00$3,526.20$163.44$2,803.33$5,289.30
Divine Providence HospitalWilliamsportPA15$5,877.00$3,526.20$163.44$2,803.33$5,289.30
Lock Haven HospitalLock HavenPA15$5,877.00$3,526.20$163.44$2,803.33$5,289.30
Upmc St MargaretPittsburghPA12$6,930.00$4,158.00$163.44$1,988.91$5,890.50
Upmc MckeesportMckeesportPA13$5,056.00$3,033.60$163.44$1,964.26$4,297.60
Upmc East HospitalMonroevillePA13$5,092.00$3,055.20$163.44$1,945.14$4,393.81
Upmc Northwest HospitalSenecaPA13$3,554.00$2,132.40$163.44$1,894.12$3,704.00
Upmc Mercy HospitalPittsburghPA16$4,964.00$2,978.40$163.44$1,886.32$4,520.78
Upmc Bedford Memorial HospitalEverettPA17$2,761.00$1,656.60$156.01$1,711.82$2,493.18
Upmc Horizon HospitalGreenvillePA17$4,127.00$2,476.20$163.44$1,609.53$3,507.95
Thomas Jefferson Univ. HospitalPhiladelphiaPA8$2,759.00$1,071.57$193.15$1,563.50$7,560.00
Upmc HamotEriePA16$5,207.00$3,124.20$163.44$1,473.76$4,165.60
Upmc PassavantPittsburghPA14$3,690.00$2,214.00$163.44$1,254.60$4,393.81
Temple University HospitalPhiladelphiaPA20$6,328.00$208.01$1,191.65$6,368.00
American Oncologic HospialPhiladelphiaPA16$6,328.00$238.95$1,146.11$6,316.00
Jeanes HospitalPhiladelphiaPA18$6,328.00$280.15$1,048.65$4,300.00
Latrobe Area HospitalLatrobePA0$1,900.00$1,140.00
Presbyterian Medical CenterPhiladelphiaPA0$4,273.00$4,273.00
Pennsylvania Hospital Of UphsPhiladelphiaPA0$4,134.00$4,134.00
Milton S. Hershey Medical CenterHersheyPA0$6,094.00$2,018.94
Physicians Care Surgical HospitalRoyersfordPA0$5,944.00$10,218
Hampden Medical CenterEnolaPA0$6,094.00$1,917.78
Meyersdale Community HospitalMeyersdalePA0$2,814.49$1,125.80
Reading Hospital And Medical CenterReadingPA0$408.00$285.60
Miners HospitalHastingsPA0$2,792.20$1,116.88
Uniontown HospitalUniontownPA0$2,453.00$1,226.50
Lifecare Hospitals Of Chester CountyWest ChesterPA0$475.00$475.00
Penn State Hershey Rehabilitation LlHummelstownPA0$6,094.00$1,585.05
Windber Hospital Inc.WindberPA0$613.00$521.05
Holy Spirit HospitalCamp HillPA0$6,094.00$1,455.86
Hospital Of The Univ Of PennaPhiladelphiaPA0$4,134.00$4,134.00
Wayne Memorial HospitalHonesdalePA0$1,968.00$1,377.60
Miners HospitalHastingsPA0$2,792.20$1,116.88
Westmoreland Regional HospitalGreensburgPA0$1,900.00$1,140.00
St. Joseph Medical CenterReadingPA0$6,094.00$1,585.05
Butler Memorial HospitalButlerPA0
The Chester County HospitalWest ChesterPA0$475.00$475.00
Doylestown HospitalDoylestownPA0$4,686.50$4,686.50
Clarion HospitalClarionPA0
Frick HospitalMount PleasantPA0$1,900.00$1,140.00

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.