CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: White River Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $918
Cash Discount Price: $470
vs. Medicare Baseline: 0.99x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at White River Medical Center is $918. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $470. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.99x the Medicare baseline. Located in 1710 Harrison Street, Batesville, AR.

Cash / Self-Pay

$470

Average discount available for prompt cash payment at this facility.

Insurance Median

$918

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: $470 (51%)

Insurance Median: $918 (99%)

Cash: $470 (51% of Medicare)

Ins. Median: $918 (99% 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
Blue Cross Blue Shield	$100 - $918	11%
Municipal Health Benefit Fund	$193 - $510	21%
Multiplan	$241 - $637	26%
Aetna	$303 - $918	33%
Arkansas Total Care	$386	42%
Summit Community Care	$386	42%
Arkansas Superior Select Wrmc	$918	99%
Hmo Partners Inc Wrmc	$918	99%
Medipak Advantage Wrmc	$918	99%
UnitedHealthcare	$918	99%
Medicare (plans)	$936	101%
Cigna	$946	102%
Allwell Wrmc	$964	104%
Wellcare Wrmc	$964	104%
Ambetter / Centene	$1,285	139%
Qualchoice (Alliance) Wrmc	$1,406	152%
Provider Network Of America Wrmc	$1,469	159%
Vantage Health Plan Wrmc	$2,571	277%

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 $470.
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 White River 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.