CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: USA Health University Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$418

about 0.5× the $927 Medicare rate · typically $196–$802

modeled estimate · not a bill or quote

What this hospital charges insurers

$419

About the fair price

about $1 over the fair price · 0.5× Medicare

Medicare pays $927 Fair price $418 This hospital $419 Cash price $1,046 Hospital's list price $1,046

How we calculate the fair BaseRate →

How this hospital compares to other AL hospitals

One of the lower prices — 7 of 8 other AL hospitals charge more for the same procedure.

Cheapest $318 Priciest $809

Black dot = this hospital, among the 9 AL hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $418 (about 0.5× the $927 Medicare rate). USA Health University Hospital charges insurers about $419, or about $1,046 in cash — about the fair price. Located in Mobile, AL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$419 - $801	45%
Blue Cross Blue Shieldmajor	$410	44%
Aetnamajor	$419 - $1,032	45%
Cignamajor	$419 - $893	45%
Humanamajor	$419 - $1,219	45%
Ambetter (Centene)	$503	54%
Devoted Health	$419 - $1,313	45%
Molina	$461 - $739	50%
WellCare	$419	45%
+ 6 smaller / regional plans	$419 - $1,688

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,046), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm USA Health University Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at USA Health University Hospital

Compare: Upper endoscopy with biopsy at other AL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.