CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Sharp Memorial Hospital
Billing Code: 43239 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$1,213
about 1.3× the $927 Medicare rate · typically $905–$1,624
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $1,213 Cash price $3,014 Hospital's list price $4,019
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 |
|---|---|---|
| UnitedHealthcaremajor | $1,929 | 208% |
| Blue Cross Blue Shieldmajor | $3,014 | 325% |
| Aetnamajor | $1,366 - $3,617 | 147% |
| Cignamajor | $563 - $3,296 | 61% |
| Health Net | $3,215 | 347% |
| Molina | $2,552 | 275% |
| + 2 smaller / regional plans | $2,813 - $3,095 |
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Other Procedures at Sharp Memorial Hospital
Compare: Upper endoscopy with biopsy at other CA hospitals
- Kern Valley Healthcare District · Lake Isabella $125
- Mayers Memorial Hospital · Fall River Mills $127
- Plumas District Hospital · Quincy $129
- Natividad Medical Center · Salinas $153
- Adventist Health Tulare · Tulare $154
- Adventist Health Tehachapi Valley · Tehachapi $163
- Adventist Health Ukiah Valley · Ukiah $171
- Adventist Health Bakersfield · Bakersfield $175
Insurance negotiated median for the same procedure, sorted lowest first.