CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Providence St. Jude Medical Center
Billing Code: 43239 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$1,635
about 1.8× the $927 Medicare rate · typically $1,206–$2,583
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $1,635 Cash price $1,076 Hospital's list price $2,241
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 | $3,465 - $3,746 | 374% |
| Blue Cross Blue Shieldmajor | $1,222 - $15,614 | 132% |
| Aetnamajor | $1,167 - $4,035 | 126% |
| Health Net | $2,158 - $3,462 | 233% |
| + 1 smaller / regional plan | $992 |
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Other Procedures at Providence St. Jude Medical Center
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.