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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in SD

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Hospitals
2
Min
$3,902.63
Median
$5,677
Max
$5,677
Range multiplier
1.5×

By payer (32 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
TRICARE19$926$926$9261.0×
Blue Cross Blue Shield28$926$2,672$5,6776.1×
UnitedHealthcare26$926$3,902.63$5,6776.1×
medica (commercial) 94265 [3081118]13$5,436.4$5,436.4$5,436.41.0×
Humana23$926$5,677$5,894.896.4×
healthpartners [3081368]13$926$926$9261.0×
govt employees health assn [3081090]13$3,902.63$3,902.63$3,902.631.0×
Cigna13$4,384.31$4,384.31$4,384.311.0×
Aetna13$5,894.89$5,894.89$5,894.891.0×
Meritain Health12$4,384.31$4,384.31$4,384.311.0×
Medicare22$926$3,301.5$5,6776.1×
national telephone cooperative assn 52103 [3081149]12$3,902.63$3,902.63$3,902.631.0×
risk admin svs [3081167]12$3,238.12$3,238.12$3,238.121.0×
key benefit administrators [3081332]11$4,384.31$4,384.31$4,384.311.0×
employee benefit management 12x44 [3081079]11$5,567.41$5,567.41$5,567.411.0×
allied benefit systems inc [3081320]11$4,384.31$4,384.31$4,384.311.0×
coresource 38225 [3081146]11$4,257.43$4,257.43$4,257.431.0×
midlands choice 47080 [3081136]11$4,384.31$4,384.31$4,384.311.0×
minnesota health care programs 12k16 [3081295]11$1,984.62$1,984.62$1,984.621.0×
Multiplan11$3,327.16$3,327.16$3,327.161.0×
va black hills health care system 12115 [3081206]11$926$926$9261.0×
pacificsource health plans [3081333]11$5,567.41$5,567.41$5,567.411.0×
preferred one 41147 [3081160]11$4,384.31$4,384.31$4,384.311.0×
va ccn optum [3081339]11$926$926$9261.0×
rocky mountain admin llc 83028 [3081168]11$5,239.9$5,239.9$5,239.91.0×
sanford health plan 91184 [3081174]11$5,447.89$5,447.89$5,447.891.0×
surest [3081369]11$3,902.63$3,902.63$3,902.631.0×
tlc advantage llc [3081189]11$6,156.89$6,156.89$6,156.891.0×
avera health plans 46045 [3081018]11$4,449.11$4,449.11$4,449.111.0×
health partners sx009 [3081102]11$3,528.09$3,528.09$3,528.091.0×
group and pension administrators inc [3081098]11$3,327.16$3,327.16$3,327.161.0×
fedmed inc [3081283]11$6,222.4$6,222.4$6,222.41.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
MONUMENT HEALTH SPEARFISH HOSPITALSPEARFISHSD4$13,204$6,911.01$2,665$5,677$5,677
MONUMENT HEALTH RAPID CITY HOSPITALRAPID CITYSD32$6,549.88$6,549.88$926$3,902.63$6,222.4

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.