CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Dch Regional Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $904
Cash Discount Price: $665
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Dch Regional Medical Center is $904. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $665. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.98x the Medicare baseline. Located in 809 University Boulevard East, Tuscaloosa, AL.

Cash / Self-Pay

$665

Average discount available for prompt cash payment at this facility.

Insurance Median

$904

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)

Cash / Self-Pay: $665 (72%)

Insurance Median: $904 (98%)

Cash: $665 (72% of Medicare)

Ins. Median: $904 (98% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$383	41%
Choicecare	$532	57%
Al. Dept Of Mental Health	$665	72%
Aetna	$731 - $922	79%
Cigna	$731	79%
Healthnet	$731	79%
Humana	$798 - $904	86%
Blue Cross Blue Shield	$904	98%
Medicare (plans)	$904	98%
Simpra	$904	98%
UnitedHealthcare	$904 - $1,329	98%
Viva	$904	98%
Workers Comp	$1,130	122%
Healthspring	$1,329	143%
Seven Corners	$1,537	166%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $665.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Dch Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.