CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Adventist Health St Helena

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$622
about 0.7× the $927 Medicare rate · typically $275–$3,635
modeled estimate · not a bill or quote
What this hospital charges insurers
$581
About the fair price
about $41 under the fair price · 0.6× Medicare
Medicare pays $927 Fair price $622 This hospital $581 Cash price $326 Hospital's list price $2,172

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $125 Priciest $581

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

A fair price for a Upper endoscopy with biopsy is about $622 (about 0.7× the $927 Medicare rate). Adventist Health St Helena charges insurers about $581, or about $326 in cash — about the fair price. Located in Saint Helena, CA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

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
UnitedHealthcaremajor $182 - $2,442 20%
Blue Cross Blue Shieldmajor $136 - $10,891 15%
Aetnamajor $254 - $5,628 27%
Cignamajor $171 - $3,064 18%
Kaiser Permanentemajor $136 - $3,141 15%
Health Net $2,348 253%
+ 5 smaller / regional plans $149 - $18,756
Government programs also on file: Medicaid, Military & VA.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals