Upper endoscopy with biopsy
Facility: Gadsden Regional Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,119
- Cash Discount Price: $5,600
- vs. Medicare Baseline: 1.21x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Veterans Eval Services | $318 | 34% |
| Medicaid / KanCare | $383 | 41% |
| Blue Cross Blue Shield | $800 | 86% |
| Humana | $800 | 86% |
| Medicare (plans) | $800 | 86% |
| Node Viva Mcr Adv | $800 | 86% |
| Node Select Health Mcr Adv | $808 | 87% |
| Amedisys Hospice | $813 | 88% |
| Gadsden Hospice | $813 | 88% |
| Node Non Par Hospice Agree | $813 | 88% |
| Node Va | $813 | 88% |
| Southern Care Hospice | $813 | 88% |
| UnitedHealthcare | $813 - $4,495 | 88% |
| Cigna | $816 - $4,809 | 88% |
| Node Devoted Health Mcr Adv | $816 | 88% |
| Node Clover Health Mcr Adv | $822 | 89% |
| Aetna | $824 - $24,173 | 89% |
| Node Wellcare Mcr Adv | $830 | 90% |
| Node Eon Mcr Adv | $840 | 91% |
| Prime Health | $856 - $33,716 | 92% |
| Node Us Dept Of Labor | $1,017 | 110% |
| Ambetter / Centene | $1,220 | 132% |
| Viva Healthcare | $3,900 | 421% |
| Tricare | $4,975 | 537% |
| Node Champva | $5,237 | 565% |
| Self Pay | $5,600 | 604% |
| American Employee Alliance | $18,666 | 2014% |
| Multiplan | $26,599 - $29,399 | 2871% |
| Magellan Behavioral | $27,999 | 3022% |
| First Health | $32,666 - $37,682 | 3525% |
| Beech Street | $34,066 | 3676% |
| Alamed Wc | $34,999 | 3777% |
| Focus Health | $35,699 | 3853% |
| Coventry Work Comp Al | $36,492 | 3938% |
| Work Comp | $39,665 | 4281% |