CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Petaluma Valley Hospital
Billing Code: 43239 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$2,116
about 2.3× the $927 Medicare rate · typically $1,208–$3,766
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $2,116 Cash price $1,519 Hospital's list price $2,979
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
3 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 | $4,657 - $5,208 | 503% |
| Blue Cross Blue Shieldmajor | $2,570 - $3,135 | 277% |
| Aetnamajor | $1,247 - $11,153 | 135% |
| Health Net | $1,222 - $6,127 | 132% |
Self-Pay How to get the cash price
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Other Procedures at Petaluma Valley 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.