CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Kingman Regional Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $556
Cash Discount Price: $451
vs. Medicare Baseline: 0.60x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Kingman Regional Medical Center is $556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.60x the Medicare baseline. Located in 3269 Stockton Hill Road, Kingman, AZ.

Cash / Self-Pay

$451

Average discount available for prompt cash payment at this facility.

Insurance Median

$556

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: $451 (49%)

Insurance Median: $556 (60%)

Cash: $451 (49% of Medicare)

Ins. Median: $556 (60% 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
Health Choice Generations	$121	13%
Hpn Sierra Nevada Mcr Adv	$121	13%
Medicare (plans)	$121	13%
Triwest - All Plans	$121	13%
Care 1St Mcr Adv-All Other Plans	$127	14%
Mercy Care Adv Snp-All Other Plans	$133	14%
Humana	$136 - $560	15%
Apipa - Ahcccs-All Other Plans	$140	15%
Health Choice Az	$140	15%
Care 1St Mcaid	$147	16%
Mercy Care Ahcccs Ddd	$154	17%
UnitedHealthcare	$155 - $606	17%
Geo Group Chc Az State Prison-All Plans	$182	20%
Aetna	$188	20%
Health Plan Of Nevada-All Other Plans	$188	20%
Health Choice Hie Exchange	$206	22%
Multiplan-All Plans	$206	22%
Blue Cross Blue Shield	$260	28%
Health Choice- All Other Plans	$303	33%
Cigna	$552	60%
Three Rivers-All Plans	$972 - $1,295	105%
America'S Choice Provider Network-All Plans	$1,003 - $1,338	108%
Az Foundation-All Plans	$1,056 - $1,408	114%
Mediversal-All Plans	$1,056 - $1,408	114%
One Health Plan-All Plans	$1,056 - $1,408	114%
Universal Health-All Plans	$1,056 - $1,408	114%

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 $451.
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 Kingman 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.