Upper endoscopy with biopsy
Facility: Medical Center Enterprise
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $830
- Cash Discount Price: $3,893
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Al Maternity Waiver Program | $291 | 31% |
| Veterans Eval Services | $318 | 34% |
| Medicaid / KanCare | $383 - $643 | 41% |
| Blue Cross Blue Shield | $769 - $1,263 | 83% |
| Humana | $769 | 83% |
| Medicare (plans) | $769 | 83% |
| UnitedHealthcare | $769 - $2,468 | 83% |
| Select Health | $777 | 84% |
| Covenant Hospice | $782 | 84% |
| Dayspring Hospice | $782 | 84% |
| Node Hospice Non Par | $782 | 84% |
| Node Va | $782 | 84% |
| Southerncare Hospice | $782 | 84% |
| Healthspring | $785 | 85% |
| Node Devoted Health Mcr Adv | $785 | 85% |
| Node Clover Mcr Adv | $790 | 85% |
| Aetna | $792 - $30,281 | 85% |
| Node Wellcare Mcr Adv | $797 | 86% |
| Eon Health | $808 | 87% |
| Wiregrass Hospice | $830 | 90% |
| Node Us Dept Of Labor | $977 | 105% |
| Ambetter / Centene | $1,173 | 127% |
| Cigna | $1,342 - $8,291 | 145% |
| Occunet | $1,368 | 148% |
| Self Pay | $3,893 | 420% |
| Tricare | $6,504 | 702% |
| Node Champva | $6,846 | 739% |
| American Employee Alliance | $17,303 | 1867% |
| Alamed | $25,955 | 2801% |
| City Of Enterprise | $25,955 | 2801% |
| Affordable Health | $30,281 | 3268% |
| Health Choice | $30,281 | 3268% |
| Novanet Ppo | $30,281 | 3268% |
| Coventry Work Comp Al | $31,838 | 3436% |
| Multiplan | $32,011 - $33,309 | 3455% |
| Wc Dept Ind Relations | $34,607 | 3735% |
| Corvel | $36,770 | 3968% |
| Galaxy Health | $38,932 | 4201% |