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Upper GI endoscopy with biopsy

CPT 43239 · negotiated-rate distribution across hospitals in WI

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Hospitals
35
Min
$893.68
Median
$1,484.73
Max
$6,159.00
Range multiplier
6.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare2373$124.37$2,976.00$8,190.0065.9×
Anthem BCBS2061$124.37$1,979.00$6,159.0049.5×
wisconsin physician service1236$2,883.00$3,035.00$3,035.001.1×
common ground1236$2,450.00$2,727.00$2,727.001.1×
Medicare1432$149.94$910.39$1,195.328.0×
Molina1823$891.71$2,568.00$2,568.002.9×
VA Health1122$901.33$910.39$952.751.1×
Cigna1316$198.52$6,800.00$6,800.0034.3×
smart health714$1,274.55$1,274.55$1,333.851.0×
aspirus113$124.37$618.80$2,656.0921.4×
Humana613$130.59$1,484.73$1,484.7311.4×
trilogy1212$4,387.00$4,387.00$4,387.001.0×
Aetna1212$3,119.00$3,119.00$3,119.001.0×
aurora caregiver1212$2,450.00$2,450.00$2,450.001.0×
Blue Cross Blue Shield412$152.13$1,135.20$3,937.0025.9×
centivo1212$3,169.00$3,169.00$3,169.001.0×
hs technology1212$3,152.00$3,152.00$3,152.001.0×
everpointe elite1212$2,153.00$2,153.00$2,153.001.0×
quartz one1212$2,790.00$2,790.00$2,790.001.0×
quartz group1212$3,260.00$3,260.00$3,260.001.0×
health payment systems1212$3,350.00$3,350.00$3,350.001.0×
wps77$1,438.70$1,438.70$1,438.701.0×
network health plan57$218.45$891.71$4,326.4119.8×
prevea 36017$124.37$905.61$3,762.8030.3×
Medicaid26$161.39$1,239.31$2,395.6014.8×
security health plan26$212.70$711.06$1,372.316.5×
mercy care15$248.15$618.80$1,469.705.9×
medica [900156]35$511.82$2,167.90$2,535.005.0×
First Health35$514.96$2,181.20$3,141.906.1×
smarthealth24$1,261.86$1,261.86$1,261.861.0×
WellCare24$946.40$946.40$946.401.0×
ma wisconsin replacement [950271]23$628.00$2,660.00$3,491.005.6×
alliance33$1,396.27$1,396.27$1,396.271.0×
healthpartners [900713]33$1,730.78$2,326.73$2,673.811.5×
illinicare12$124.37$514.99$905.617.3×
medical associates health plan12$412.91$1,003.29$1,593.663.9×
health partners open network12$289.14$952.47$1,615.795.6×
meridiancare12$130.59$518.10$905.616.9×
quartz22$893.68$1,137.43$1,381.171.5×
centivo nw322$1,357.99$1,357.99$1,357.991.0×
unitedhealth group of wi12$893.68$2,809.84$4,726.005.3×
centivo nw122$1,357.99$1,357.99$1,357.991.0×
cchp22$777.06$777.06$777.061.0×
icare22$891.71$923.98$956.241.1×
veteran's administration (va ccn)11$893.68$893.68$893.681.0×
health partners11$891.71$891.71$891.711.0×
group health cooperative of eau claire11$947.30$947.30$947.301.0×
security health plan (shp)11$893.68$893.68$893.681.0×
community care incorporated11$891.71$891.71$891.711.0×
allwell11$909.55$909.55$909.551.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Amery Regional Medical CenterAmeryWI6$2,660.00$1,386.92$149.94$961.26$2,673.81
All Saints - St. Luke S HospitalRacineWI4$952.75$952.75$1,438.70
Wheaton Franciscan Healthcare - AllRacineWI4$952.75$952.75$1,438.70
Wheaton Franciscan - FranklinFranklinWI4$910.39$910.39$1,438.70
Wfhc - Elmbrook MemorialBrookfieldWI4$910.39$910.39$1,438.70
Ascension Se Wisconsin Hospital IncMilwaukeeWI4$910.39$910.39$1,438.70
Ascension Wisconsin Emerus MenomoneeMenomonee FallsWI4$910.39$910.39$1,438.70
MoshFranklinWI4$910.39$910.39$1,438.70
Meriter Hospital Inc.MadisonWI14$4,426.82$3,541.46$124.37$905.61$5,169.00
Mercy Medical CenterOshkoshWI9$143.11$901.33$1,892.79
Ascension Ne Wisconsin-St. ElizabethAppletonWI9$143.11$901.33$1,892.79
Holy Family Memorial IncManitowocWI10$891.71$900.63$6,312.00
Beaver Dam Community HospitalsBeaver DamWI11$893.68$893.68$5,571.00
Childrens Hospital Of Wi-Fox ValleyNeenahWI2$5,749.00$6,159.00$8,190.00
Ssh - Fox ValleyOshkoshWI2$5,749.00$6,159.00$8,190.00
Childrens WisconsinMilwaukeeWI2$5,749.00$6,159.00$8,190.00
Aurora Medical Center - Bay AreaMarinetteWI15$2,020.00$2,976.00$6,800.00
Aurora Health Care Metro Inc.MilwaukeeWI15$1,979.00$2,976.00$6,800.00
West Allis Memorial HospitalWest AllisWI15$1,979.00$2,976.00$6,800.00
Memorial Hospital Of BurlingtonBurlingtonWI15$1,979.00$2,976.00$6,800.00
Aurora Medical Center KenoshaKenoshaWI15$1,979.00$2,976.00$6,800.00
Aurora Medical Center Of OshkoshOshkoshWI15$1,979.00$2,976.00$6,800.00
Aurora Medical Center - HartfordHartfordWI15$1,979.00$2,976.00$6,800.00
Aurora Medical Center - SummitSummitWI15$1,979.00$2,976.00$6,800.00
Aurora Medical Center GraftonGraftonWI15$1,979.00$2,976.00$6,800.00
Sheboygan Memorial HospitalSheboyganWI15$1,979.00$2,976.00$6,800.00
Aurora Med Ctr Of Manitowoc CountyTwo RiversWI15$1,979.00$2,976.00$6,800.00
Aurora Lakeland Medical CenterElkhornWI15$1,979.00$2,976.00$6,800.00
Hudson HospitalHudsonWI8$3,491.00$1,574.79$1,135.20$1,507.74$3,912.00
Ascension Sacred Heart RehabilitatioMilwaukeeWI4$4,375.00$2,318.75$218.45$1,484.73$1,484.73
Ascension Columbia St Marys MilwaukeMilwaukeeWI7$218.45$1,440.50$2,007.94
Ascension Columbia St Marys OzaukeeMequonWI7$4,375.00$2,318.75$218.45$1,440.50$2,007.94
Westfields HospitalNew RichmondWI8$2,660.00$1,399.16$149.94$1,090.60$2,660.00
University Of Wi Hospitals & ClinicsMadisonWI0$8,040.00$4,824.00
Uw Health Rehabilitation HospitalMadisonWI0$8,040.00$4,824.00

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.