Payer comparison · HCPCS 43265 · ONEIDA, NY

43265 — Ercp Lithotripsy Calculi

What each payer pays ONEIDA HEALTH HOSPITAL (CCN 330115) for this procedure, and where each sits versus the all-payer median at this facility. Find your plan to see whether you're above or below the market here.

$4,488 All-payer median here

$4,932 Cash / self-pay here

32 payer/plan-name variants

← This hospital National rates for 43265 →

Per-payer negotiated rate at this facility. Use the column headers to sort, the filter row to narrow results.
Payer / plan	Median negotiated	vs all-payer median	Rate rows

BLUECROSS	$16,029	257.1%	2
MultiPlan	$8,497	89.3%	4
EmblemHealth	$8,497	89.3%	4
CASH	$8,219	83.1%	4
WellCare Health Plans	$7,256	61.7%	2
Aetna	$7,049	57.1%	6
Humana	$7,044	57.0%	2
TRICARE	$7,044	57.0%	2
Medicare (Generic)	$7,044	57.0%	2
MCRBLUE	$7,044	57.0%	2
Martin's Point Health Care, Inc.	$7,044	57.0%	2
POMCO Group	$6,987	55.7%	8
CAPITAL DISTRICT PHYSICIANS HEALTH PLAN (CDPHP)	$6,446	43.6%	8
MCRCDPHP	$4,998	11.4%	4
UnitedHealthcare	$4,130	-8.0%	12
FIDELIS CARE (CENTERCARE)	$1,921	-57.2%	14
MVP Health Care	$1,478	-67.1%	8
AMISH_ED	$1,425	-68.2%	2
AMISH_ASU	$1,397	-68.9%	2
MEDICAID_1402	$1,295	-71.1%	2
Medicaid (Generic)	$1,270	-71.7%	2
BLUE-SP_1402	$1,216	-72.9%	2
BLUE-CHP_1402	$1,216	-72.9%	2
BLUE-MCD_1402	$1,216	-72.9%	2
BLUE-CHP_1401	$1,192	-73.4%	2
MVP-MCD_1401	$1,192	-73.4%	2
BLUE-SP_1401	$1,192	-73.4%	2
BLUE-MCD_1401	$1,192	-73.4%	2
MEDICAID_1432	$1,181	-73.7%	2
BLUE-SP_1432	$1,109	-75.3%	2
BLUE-CHP_1432	$1,109	-75.3%	2
BLUE-MCD_1432	$1,109	-75.3%	2

Median over current-blob negotiated rates (COALESCE of standard / median / min–max midpoint, $0.01–$5M sentinel guard). Payers are canonical-grouped where a mapping exists; unmapped regional-plan name variants may appear as separate rows.