Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
HC G-ESOPH REFLX TST W/ELECTROD
Lititz, PA
See all hospitals reporting CPT 91035 →Price type
UPMC Lititz’s median price of $823 is 12% below the median hospital's median price ($940), higher than 36% of the 1,903 hospitals reporting CPT 91035. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 7 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield medicare advantage facility · percent of total billed charges · outpatientfrom % of charges | $370 | $370 | — | — | — | $370 – $370 |
| 2 | UnitedHealthcare pa medicaid facility · fee schedule · outpatient | $374 | $374 | — | — | — | $374 – $374 |
| 3 | Amerihealth Caritas community healthchoices (chc)/medicaid facility · fee schedule · outpatient | $446 | $446 | — | — | — | $446 – $446 |
| 4 | Highmark medicare facility · fee schedule · outpatient | $505 | $505 | — | — | — | $505 – $505 |
| 5 | Aetna medicare facility · fee schedule · outpatient | $532 | $532 | — | — | — | $532 – $532 |
| 6 | Cigna medicare facility · fee schedule · outpatient | $535 | $535 | — | — | — | $535 – $535 |
| 7 | UnitedHealthcare medicare facility · fee schedule · outpatient | $545 | $545 | — | — | — | $545 – $545 |
| 8 | Aetna aco facility · percent of total billed charges · inpatientfrom % of charges | $692 | $692 | — | — | — | $692 – $692 |
| 9 | Aetna aco facility · percent of total billed charges · outpatientfrom % of charges | $727 | $727 | — | — | — | $727 – $727 |
| 10 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $823 | $823 | — | — | — | $823 – $823 |
| 11 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $865 | $865 | — | — | — | $865 – $865 |
| 12 | Blue Cross Blue Shield chip facility · percent of total billed charges · outpatientfrom % of charges | $867 | $867 | — | — | — | $867 – $867 |
| 13 | Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges | $867 | $867 | — | — | — | $867 – $867 |
| 14 | Highmark medicaid facility · fee schedule · outpatient | $1.0k | $1.0k | $561 | 56% | — | $446 – $1.6k |
| 15 | Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges | $1.4k | $1.4k | — | — | — | $1.4k – $1.4k |
| 16 | Highmark commercial - children's health insurance facility · fee schedule · outpatient | $1.5k | $1.5k | — | — | — | $1.5k – $1.5k |
| 17 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · inpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 18 | MultiPlan ppo (includes phcs and humana as payers) facility · percent of total billed charges · outpatientfrom % of charges | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
| 19 | Highmark commercial facility · fee schedule · outpatient | $1.6k | $1.6k | — | — | — | $1.6k – $1.6k |
Last updated: Mar 6, 2026
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