Upper endoscopy with biopsy
Facility: Flowers Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,356
- Cash Discount Price: $5,678
- vs. Medicare Baseline: 1.46x 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% |
| Alabama Rehab | $383 | 41% |
| Medicaid / KanCare | $383 - $643 | 41% |
| Blue Cross Blue Shield | $860 - $1,400 | 93% |
| Humana | $860 | 93% |
| Medicare (plans) | $860 | 93% |
| Node Viva Mcr Adv | $860 | 93% |
| UnitedHealthcare | $860 - $3,200 | 93% |
| Select Health | $868 | 94% |
| Compassionate Hands | $874 | 94% |
| Covenant Hospice | $874 | 94% |
| Dayspring Hospice | $874 | 94% |
| Node Hospice Non Par | $874 | 94% |
| Node Va | $874 | 94% |
| Southern Care Hospice | $874 | 94% |
| Vistacare Hospice | $874 | 94% |
| Wiregrass Hospice | $874 | 94% |
| Care Improvement Plus | $877 | 95% |
| Cigna | $877 | 95% |
| Node Devoted Health Mcr Adv | $877 | 95% |
| Node Clover Health Mcr Adv | $882 | 95% |
| Aetna | $885 - $27,632 | 96% |
| Node Wellcare Mcr Adv | $891 | 96% |
| Eon Health Care | $903 | 97% |
| Prime Health | $920 - $26,705 | 99% |
| Node Us Dept Of Labor | $1,092 | 118% |
| Ambetter / Centene | $1,311 | 141% |
| Occunet | $1,529 | 165% |
| Tricare | $4,059 | 438% |
| Node Champva | $4,273 | 461% |
| Self Pay | $5,678 | 613% |
| S & S Healthcare | $9,463 | 1021% |
| Choicecare Commercial | $13,248 | 1430% |
| American Employee Alliance | $15,141 | 1634% |
| Coventry Healthcare | $18,926 - $28,904 | 2042% |
| Viva Health | $22,712 | 2451% |
| Multiplan | $24,604 - $30,282 | 2655% |
| Standard Textile | $26,497 | 2860% |
| Alamed Wc | $26,705 | 2882% |
| Health Choice | $27,632 | 2982% |
| Equian | $28,389 - $29,847 | 3064% |
| Qhp | $28,389 | 3064% |
| Novanet | $30,282 | 3268% |
| Alabama Work Comp | $31,418 | 3391% |
| Ccn/Mednet Ppo | $32,175 | 3472% |
| Corvel | $32,175 | 3472% |
| Industry Buying Group | $32,175 | 3472% |
| Galaxy Health | $34,067 | 3676% |
| Health Payors Org | $34,067 | 3676% |
| National Provider Net | $34,067 | 3676% |