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Pick a procedure and (optionally) a state or payer. Rates come from each hospital's federally-mandated machine-readable file.

ProcedureHospital (name or CCN)State

Payer

Hospitals

Payers

Negotiated range

$12.84 – $11,584

Negotiated median

$950.52

CPT 43239 Upper GI endoscopy with biopsy · Showing 164 of 231 rate rows

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Hospital	ST	Payer	Plan	Setting	Type	Rate
SOUTHERN REGIONAL MEDICAL CENTER	GA	Chargemaster	N/A	outpatient	gross	$4,131.95
DODGE COUNTY HOSPITAL	GA	Chargemaster	N/A	inpatient	gross	$1,582.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Chargemaster	N/A	outpatient	gross	$285
HOUSTON MEDICAL CENTER	GA	Cash pay	N/A	—	cash	$1,672.3
PERRY HOSPITAL	GA	Cash pay	N/A	—	cash	$1,672.3
SOUTHERN REGIONAL MEDICAL CENTER	GA	Cash pay	N/A	outpatient	cash	$905
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Cash pay	N/A	outpatient	cash	$211.47
SOUTHWELL MEDICAL	GA	[De-identified Min]	—	outpatient	min	$5,461.13
ST. MARYS SACRED HEART HOSPITAL	GA	[De-identified Min]	—	inpatient	min	$941.1
HOUSTON MEDICAL CENTER	GA	[de-identified min]	—	—	min	$743.25
PERRY HOSPITAL	GA	[de-identified min]	—	—	min	$743.25
SOUTHERN REGIONAL MEDICAL CENTER	GA	[De-identified Min]	—	outpatient	min	$530.54
UNION GENERAL HOSPITAL	GA	[De-identified Min]	—	outpatient	min	$312.51
WEST CENTRAL GA REGIONAL HOSPITAL	GA	[De-identified Min]	—	outpatient	min	$143.76
DODGE COUNTY HOSPITAL	GA	[De-identified Min]	—	inpatient	min	$1
ST. MARYS SACRED HEART HOSPITAL	GA	Aetna	2494_AETNA PSH 20250701	outpatient	negotiated	$11,584
HOUSTON MEDICAL CENTER	GA	Cigna	—	—	negotiated	$4,917
HOUSTON MEDICAL CENTER	GA	phcs op rate	—	—	negotiated	$4,409.09
HOUSTON MEDICAL CENTER	GA	beech street op rate	—	—	negotiated	$4,313.24
HOUSTON MEDICAL CENTER	GA	Humana	—	—	negotiated	$4,113
HOUSTON MEDICAL CENTER	GA	Blue Cross Blue Shield	—	—	negotiated	$4,043.91
PERRY HOSPITAL	GA	First Health	—	—	negotiated	$3,768
HOUSTON MEDICAL CENTER	GA	First Health	—	—	negotiated	$3,768
HOUSTON MEDICAL CENTER	GA	UnitedHealthcare	—	—	negotiated	$3,250
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Health Net	Commercial\|All Plans	outpatient	negotiated	$2,570.5
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Aetna	Commercial\|PPO	outpatient	negotiated	$2,385
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Aetna	Commercial\|All Other Plans	outpatient	negotiated	$2,385
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Cigna	Commercial\|All Other Plans	outpatient	negotiated	$2,313.45
WEST CENTRAL GA REGIONAL HOSPITAL	GA	UnitedHealthcare	Commercial\|All Other Plans	outpatient	negotiated	$2,305.5
SOUTHERN REGIONAL MEDICAL CENTER	GA	Aetna	Aetna PPO	outpatient	negotiated	$2,297.2
SOUTHERN REGIONAL MEDICAL CENTER	GA	Aetna	Aetna HMO	outpatient	negotiated	$2,297.2
PERRY HOSPITAL	GA	secure health op rate	—	—	negotiated	$2,260
HOUSTON MEDICAL CENTER	GA	secure health op rate	—	—	negotiated	$2,260
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Cigna	Commercial\|IFP	inpatient	negotiated	$2,252.5
ST. MARYS SACRED HEART HOSPITAL	GA	occunet	2603_MEDICARE ADVANTAGE OCCUNET INPATIENT 20251001	inpatient	negotiated	$2,117.47
PERRY HOSPITAL	GA	alliant op rate	—	—	negotiated	$2,051
HOUSTON MEDICAL CENTER	GA	alliant op rate	—	—	negotiated	$2,051
SOUTHERN REGIONAL MEDICAL CENTER	GA	Cigna	Cigna Commercial	outpatient	negotiated	$1,887.67
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBS Pathway Adhoc	outpatient	negotiated	$1,816.56
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBS Pathway	outpatient	negotiated	$1,816.56
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBS HMO Adhoc	outpatient	negotiated	$1,816.56
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBS HMO	outpatient	negotiated	$1,816.56
ST. MARYS SACRED HEART HOSPITAL	GA	occunet	2114_MEDICARE ADVANTAGE OCCUNET OUTPATIENT 20221201	outpatient	negotiated	$1,741.04
SOUTHERN REGIONAL MEDICAL CENTER	GA	CareSource	Caresource Exchange	outpatient	negotiated	$1,584.21
ST. MARYS SACRED HEART HOSPITAL	GA	Ambetter	2611_SUNSHINE HEALTH AMBETTER COMMERCIAL INPATIENT PSH 20251001	inpatient	negotiated	$1,552.82
ST. MARYS SACRED HEART HOSPITAL	GA	Ambetter	2426_SUNSHINE HEALTH AMBETTER COMMERCIAL OUTPATIENT PSH 20250101	outpatient	negotiated	$1,552.82
ST. MARYS SACRED HEART HOSPITAL	GA	Oscar Health	2456_OSCAR HEALTH PLAN OUTPATIENT 20250401	outpatient	negotiated	$1,505.76
ST. MARYS SACRED HEART HOSPITAL	GA	Oscar Health	2609_OSCAR HEALTH PLAN INPATIENT 20251001	inpatient	negotiated	$1,505.76
DODGE COUNTY HOSPITAL	GA	Cigna	PPO	outpatient	negotiated	$1,424.04
SOUTHERN REGIONAL MEDICAL CENTER	GA	naphcare	Naphcare Prison	outpatient	negotiated	$1,403.15
SOUTHERN REGIONAL MEDICAL CENTER	GA	centurion	Centurion	outpatient	negotiated	$1,357.89
ST. MARYS SACRED HEART HOSPITAL	GA	smarthealth	2442_SMARTHEALTH OUTPATIENT 20250101	outpatient	negotiated	$1,317.54
ST. MARYS SACRED HEART HOSPITAL	GA	smarthealth	2610_SMARTHEALTH INPATIENT 20251001	inpatient	negotiated	$1,317.54
SOUTHERN REGIONAL MEDICAL CENTER	GA	employer direct healthcare	Employer Direct Healthcare Commercial	outpatient	negotiated	$1,267.36
DODGE COUNTY HOSPITAL	GA	Aetna	PPO	outpatient	negotiated	$1,186.7
SOUTHERN REGIONAL MEDICAL CENTER	GA	Oscar Health	Oscar Health Plan Commercial Exchange	outpatient	negotiated	$1,176.84
HOUSTON MEDICAL CENTER	GA	dodge cty op rate	—	—	negotiated	$1,150.2
SOUTHERN REGIONAL MEDICAL CENTER	GA	riverwood behavioral health	Riverwood Behavioral Health Commercial	outpatient	negotiated	$1,131.58
PERRY HOSPITAL	GA	dodge cty op rate	—	—	negotiated	$1,129.3
SOUTHERN REGIONAL MEDICAL CENTER	GA	peach state	Peach State Ambetter Comm	outpatient	negotiated	$1,086.31
WEST CENTRAL GA REGIONAL HOSPITAL	GA	devoted health	Medicare\|All Plans	outpatient	negotiated	$1,059.23
HOUSTON MEDICAL CENTER	GA	CareSource	—	—	negotiated	$1,049.91
WEST CENTRAL GA REGIONAL HOSPITAL	GA	imperial insurance	Medicare\|All Plans	outpatient	negotiated	$1,049.24
PERRY HOSPITAL	GA	Ambetter	—	—	negotiated	$1,040.54
HOUSTON MEDICAL CENTER	GA	Ambetter	—	—	negotiated	$1,040.54
DODGE COUNTY HOSPITAL	GA	UnitedHealthcare	PPO	outpatient	negotiated	$1,036
HOUSTON MEDICAL CENTER	GA	peach state hp op rate	—	—	negotiated	$1,031.02
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Blue Cross Blue Shield	Medicare\|All Plans	outpatient	negotiated	$1,029.25
HOUSTON MEDICAL CENTER	GA	amerigroup op rate	—	—	negotiated	$1,018.75
HOUSTON MEDICAL CENTER	GA	WellCare	—	—	negotiated	$1,000.84
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Cigna	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	arizona medical network	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	united mine workers of america	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Aetna	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	rural arizona network	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Humana	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	health management network	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	banner health	Medicare\|All Plans	outpatient	negotiated	$999.27
WEST CENTRAL GA REGIONAL HOSPITAL	GA	health choice pathway	Medicare\|All Plans	outpatient	negotiated	$999.27
ST. MARYS SACRED HEART HOSPITAL	GA	Humana	2437_MEDICARE ADVANTAGE HUMANA GOLD OUTPATIENT PSH 20250101	outpatient	negotiated	$969.33
ST. MARYS SACRED HEART HOSPITAL	GA	Humana	2601_MEDICARE ADVANTAGE HUMANA GOLD INPATIENT PSH 20251001	inpatient	negotiated	$969.33
ST. MARYS SACRED HEART HOSPITAL	GA	Aetna	2429_AETNA MEDICARE ADVANTAGE OUTPATIENT PSH 20250101	outpatient	negotiated	$969.33
ST. MARYS SACRED HEART HOSPITAL	GA	Aetna	2593_AETNA MEDICARE ADVANTAGE INPATIENT PSH 20251001	inpatient	negotiated	$969.33
ST. MARYS SACRED HEART HOSPITAL	GA	healthspring mcr replacement	2599_MEDICARE ADVANTAGE CIGNA HEALTHSPRING INPATIENT PSH 20251001	inpatient	negotiated	$959.92
SOUTHERN REGIONAL MEDICAL CENTER	GA	WellCare	Wellcare Medicare	outpatient	negotiated	$950.52
SOUTHERN REGIONAL MEDICAL CENTER	GA	sonder health plan	Sonder Health Plan Duals	outpatient	negotiated	$950.52
SOUTHERN REGIONAL MEDICAL CENTER	GA	sonder health plan	Sonder Health Plan Medicare	outpatient	negotiated	$950.52
ST. MARYS SACRED HEART HOSPITAL	GA	UnitedHealthcare	2615_UHC MEDICARE ADVANTAGE INPATIENT PSH 20251001	inpatient	negotiated	$950.51
ST. MARYS SACRED HEART HOSPITAL	GA	UnitedHealthcare	2548_UHC MEDICARE ADVANTAGE OUTPATIENT PSH 20250501	outpatient	negotiated	$950.51
ST. MARYS SACRED HEART HOSPITAL	GA	healthspring mcr replacement	2435_MEDICARE ADVANTAGE CIGNA HEALTHSPRING OUTPATIENT PSH 20250101	outpatient	negotiated	$950.51
ST. MARYS SACRED HEART HOSPITAL	GA	WellCare	2493_MEDICARE ADVANTAGE WELLCARE OUTPATIENT PSH 20250101	outpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	facility billing - op	2595_FACILITY BILLING INPATIENT PSH 20251001	inpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	WellCare	2605_MEDICARE ADVANTAGE WELLCARE INPATIENT PSH 20251001	inpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	Medicare Advantage	2438_MEDICARE ADVANTAGE OUTPATIENT PSH 20250101	outpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	Medicare Advantage	2602_MEDICARE ADVANTAGE INPATIENT PSH 20251001	inpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	blue mcr replacement	2433_MEDICARE ADVANTAGE BLUE OUTPATIENT PSH 20250101	outpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	blue mcr replacement	2597_MEDICARE ADVANTAGE BLUE INPATIENT PSH 20251001	inpatient	negotiated	$941.1
ST. MARYS SACRED HEART HOSPITAL	GA	facility billing - op	1472_FACILITY BILLING OUTPATIENT PSH 20190101	outpatient	negotiated	$941.1
SOUTHERN REGIONAL MEDICAL CENTER	GA	CareSource	Caresource Duals	outpatient	negotiated	$932.42
SOUTHERN REGIONAL MEDICAL CENTER	GA	CareSource	Caresource Medicare	outpatient	negotiated	$932.42
SOUTHERN REGIONAL MEDICAL CENTER	GA	devoted health	Devoted Health	outpatient	negotiated	$932.42
SOUTHERN REGIONAL MEDICAL CENTER	GA	peach state	Peach State Medicare	outpatient	negotiated	$932.42
SOUTHERN REGIONAL MEDICAL CENTER	GA	Multiplan	Multiplan Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	Aetna	Aetna Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	americas choice provider network	Americas Choice Provider Network Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBSGA Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	Cigna	Cigna Healthspring Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	clear spring health plan	Clear Spring Health Plan	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	corvel	Corvel Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	georgia workers’ compensation	Worker Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	Medicare	Traditional Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	novanet	Novanet Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	prime health services	Prime Health Services Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	provider select	Provider Select Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	riverwood behavioral health	Riverwood Behavioral Health Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	three rivers	Three Rivers Workers Compensation	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	TRICARE	Tricare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	UnitedHealthcare	UHC Medicare	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	UnitedHealthcare	UHC VA CCN	outpatient	negotiated	$905.26
SOUTHERN REGIONAL MEDICAL CENTER	GA	Humana	Humana Medicare	outpatient	negotiated	$887.15
SOUTHERN REGIONAL MEDICAL CENTER	GA	Humana	Humana Tricare	outpatient	negotiated	$860
DODGE COUNTY HOSPITAL	GA	Medicaid	PPO	inpatient	negotiated	$844.14
DODGE COUNTY HOSPITAL	GA	Aetna	HMO	outpatient	negotiated	$790.92
DODGE COUNTY HOSPITAL	GA	Humana	PPO	outpatient	negotiated	$790.92
DODGE COUNTY HOSPITAL	GA	UnitedHealthcare	HMO	outpatient	negotiated	$790.92
PERRY HOSPITAL	GA	WellCare	—	—	negotiated	$772.97
PERRY HOSPITAL	GA	CareSource	—	—	negotiated	$758.11
PERRY HOSPITAL	GA	Aetna	—	—	negotiated	$750.68
HOUSTON MEDICAL CENTER	GA	Aetna	—	—	negotiated	$750.68
PERRY HOSPITAL	GA	UnitedHealthcare	—	—	negotiated	$743.25
PERRY HOSPITAL	GA	Humana	—	—	negotiated	$743.25
SOUTHERN REGIONAL MEDICAL CENTER	GA	Humana	Humana Commercial	outpatient	negotiated	$739.54
DODGE COUNTY HOSPITAL	GA	Blue Cross Blue Shield	PPO	inpatient	negotiated	$656.64
WEST CENTRAL GA REGIONAL HOSPITAL	GA	WellCare	Medicare\|All Plans	outpatient	negotiated	$299.25
WEST CENTRAL GA REGIONAL HOSPITAL	GA	UnitedHealthcare	Medicare\|All Plans	outpatient	negotiated	$292.13
WEST CENTRAL GA REGIONAL HOSPITAL	GA	bridgeway health solutions	Medicare\|All Plans	outpatient	negotiated	$285
WEST CENTRAL GA REGIONAL HOSPITAL	GA	First Health	Medicare\|All Plans	outpatient	negotiated	$285
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Health Net	Medicare\|Allwell	outpatient	negotiated	$285
WEST CENTRAL GA REGIONAL HOSPITAL	GA	First Health	Commercial\|All Plans	outpatient	negotiated	$270.75
WEST CENTRAL GA REGIONAL HOSPITAL	GA	UnitedHealthcare	Commercial\|Choice	outpatient	negotiated	$247.95
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Blue Cross Blue Shield	Commercial\|All Plans	outpatient	negotiated	$242.54
DODGE COUNTY HOSPITAL	GA	Medicaid	HMO	outpatient	negotiated	$155.21
WEST CENTRAL GA REGIONAL HOSPITAL	GA	health choice	Medicaid\|All Plans	outpatient	negotiated	$150.95
WEST CENTRAL GA REGIONAL HOSPITAL	GA	mercy care	Medicaid\|All Plans	outpatient	negotiated	$150.95
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Humana	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	UnitedHealthcare	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	acchs	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	arizona complete health	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	banner health	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	care 1st	Medicaid\|All Plans	outpatient	negotiated	$143.76
WEST CENTRAL GA REGIONAL HOSPITAL	GA	Health Net	Medicaid\|All Plans	outpatient	negotiated	$143.76
DODGE COUNTY HOSPITAL	GA	Blue Cross Blue Shield	HMO	outpatient	negotiated	$100
SOUTHERN REGIONAL MEDICAL CENTER	GA	Blue Cross Blue Shield	BCBS PPO	outpatient	negotiated	$58.84
SOUTHERN REGIONAL MEDICAL CENTER	GA	UnitedHealthcare	UHC Commercial	outpatient	negotiated	$37
SOUTHERN REGIONAL MEDICAL CENTER	GA	CareSource	Caresource Medicaid	outpatient	negotiated	$13.49
SOUTHERN REGIONAL MEDICAL CENTER	GA	peach state	Peach State Medicaid	outpatient	negotiated	$12.84
HOUSTON MEDICAL CENTER	GA	[de-identified max]	—	—	max	$4,917
SOUTHERN REGIONAL MEDICAL CENTER	GA	[De-identified Max]	—	outpatient	max	$4,131.95
PERRY HOSPITAL	GA	[de-identified max]	—	—	max	$3,881
ST. MARYS SACRED HEART HOSPITAL	GA	[De-identified Max]	—	outpatient	max	$2,117.47
UNION GENERAL HOSPITAL	GA	[De-identified Max]	—	outpatient	max	$944.59
DODGE COUNTY HOSPITAL	GA	[De-identified Max]	—	inpatient	max	$844.14
SOUTHWELL MEDICAL	GA	[De-identified Max]	—	outpatient	max	$555.29
WEST CENTRAL GA REGIONAL HOSPITAL	GA	[De-identified Max]	—	outpatient	max	$302.1

Rates are point-in-time snapshots from each hospital's machine-readable file. Payers can negotiate different rates for different plans within the same network — this view shows the latest snapshot per (hospital, payer, plan, rate type).