CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: PAM Health Rehabilitation Hospital of Surprise

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$339

about 0.4× the $927 Medicare rate · typically $130–$1,591

modeled estimate · not a bill or quote

What this hospital charges insurers

$125

Below the fair price — a good deal

about $214 under the fair price · 0.1× Medicare

Medicare pays $927 Fair price $339 This hospital $125 Cash price $3,801 Hospital's list price $3,801

How we calculate the fair BaseRate →

How this hospital compares to other AZ hospitals

Lowest price of the 9 AZ hospitals we have prices for — a strong deal.

Cheapest $125 Priciest $587

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $339 (about 0.4× the $927 Medicare rate). PAM Health Rehabilitation Hospital of Surprise charges insurers about $125, or about $3,801 in cash — below the fair price — a good deal. Located in Surprise, AZ.

What each insurance company pays

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

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

✓ Aetna UnitedHealthcareBlue Cross Blue ShieldCignaHumanaKaiser 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
Aetnamajor	$125	13%
+ 3 smaller / regional plans	$2,661 - $2,851

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 3,801), 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 PAM Health Rehabilitation Hospital of Surprise 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 PAM Health Rehabilitation Hospital of Surprise

Compare: Upper endoscopy with biopsy at other AZ hospitals

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