Upper endoscopy with biopsy
Facility: Oro Valley Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,105
- Cash Discount Price: $4,685
- vs. Medicare Baseline: 1.19x 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 | $349 | 38% |
| Medicaid / KanCare | $581 - $622 | 63% |
| Magellan | $610 - $11,712 | 66% |
| Aetna | $952 - $3,709 | 103% |
| Caremore Health Plan | $952 | 103% |
| Cigna | $952 - $3,883 | 103% |
| Humana | $952 | 103% |
| Medicare (plans) | $952 | 103% |
| Scan Health | $952 | 103% |
| UnitedHealthcare | $952 - $2,517 | 103% |
| Pascua Yaqui Tribe | $958 | 103% |
| Blue Cross Blue Shield | $968 - $3,608 | 104% |
| Department Of Veterans Affairs | $968 | 104% |
| Node Non Par Hospice Agree | $968 | 104% |
| Node Triwest | $968 | 104% |
| Node Va | $968 | 104% |
| Tricare | $968 | 104% |
| Fresenius Health | $971 | 105% |
| Clover Health Mcr Adv | $978 | 106% |
| Node Devoted Health Mcr Adv | $981 | 106% |
| Node Banner Mcr Adv | $1,000 | 108% |
| Wellcare Mcr Adv | $1,000 | 108% |
| Node Us Dept Of Labor | $1,210 | 131% |
| Ambetter / Centene | $1,365 | 147% |
| Node Health Choice Exchange | $1,442 | 156% |
| Node Fusion Network | $1,742 | 188% |
| Node J Allen Inmate Health Svcs | $1,839 | 198% |
| Health Net | $2,032 | 219% |
| Seven Corners | $2,226 | 240% |
| Self Pay | $4,685 | 506% |
| Beacon Health Options | $9,760 | 1053% |
| Mtc | $9,760 | 1053% |
| First Health Coventry | $10,248 | 1106% |
| Coventry Work Comp Al | $11,712 | 1264% |
| Multiplan | $16,201 | 1748% |
| Prime Health | $16,592 | 1791% |
| Three Rivers | $16,592 | 1791% |
| Healthsmart | $17,568 | 1896% |