Washington, DC · hospital rates, itemized

What would you pay for upper gi endoscopy (diagnostic)?

CPT 43235 · Washington, DC · hospital file data as of April 2, 2026, verified July 16, 2026.

Hospital price files tell you the facility rate. Your bill is your share of that rate — deductible first, then coinsurance, capped at your out-of-pocket max. The estimator does that arithmetic with your plan's actual numbers and the rate your hospital published for your insurer.

In Washington, DC right now, hospitals' median commercial rates for this procedure run $1,071 – $2,315, and cash prices $1,098 – $3,173 (7 hospitals, from their published price files — see the full comparison). Which hospital you pick usually moves the bill more than any plan detail.

How the math works — an example with a hypothetical plan

Say your plan has $500 left on its deductible, 20% coinsurance, and $4,000 left before your out-of-pocket max — and your hospital's negotiated rate equals the current Washington, DC median commercial rate for this procedure, $1,469 (real figure, from hospital price files). The plan numbers are made up for illustration; yours will differ.

You pay the rest of your deductible first$500
Then 20% coinsurance on the remaining $969$194
Subtotal, capped by your remaining out-of-pocket max ($4,000) and by the rate itself≈ $694

Estimated patient share of the facility rate only, using a hypothetical plan. Physician, anesthesia, radiology, and pathology bill separately.

Run your numbers in the estimator →
You'll need: deductible remaining, coinsurance %, out-of-pocket max remaining.

What these numbers are — and aren't. These are facility rates hospitals publish under the CMS Hospital Price Transparency rule (45 CFR Part 180). They are price information, not a quote or guarantee. Physician, anesthesia, radiology, and pathology services usually bill separately. Your actual cost depends on your insurance plan, deductible, and how the visit is coded. How we read hospital price files →

Common questions

Why isn't the published rate what I'll pay?

The published number is the facility rate your hospital negotiated with your insurer (or its cash price). What you owe is your share of it: any deductible you haven't met, then coinsurance, capped by your out-of-pocket maximum. Same rate, very different bills depending on where you are in your plan year.

What do I need to run an estimate?

Three numbers from your insurance portal or a recent EOB: how much of your deductible is left, your coinsurance percentage for hospital services, and how much is left before your out-of-pocket maximum. The estimator combines them with the hospital-published rate for your plan.

Is the estimate a quote?

No. It's arithmetic on the hospital's published facility rate and the plan numbers you enter. It excludes separately billed physician, anesthesia, radiology, and pathology services, and the final bill depends on how the visit is coded.