CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,337

about 1.4× the $927 Medicare rate · typically $920–$2,156

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $1,337 Cash price $3,014 Hospital's list price $4,019

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser 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	$1,366 - $3,939	147%
Blue Cross Blue Shieldmajor	$254 - $3,215	27%
Aetnamajor	$603 - $3,617	65%
Cignamajor	$2,010 - $3,617	217%
Humanamajor	$1,226	132%
Kaiser Permanentemajor	$1,608 - $2,773	174%
Health Net	$563 - $3,014	61%
Molina	$1,366 - $3,617	147%
+ 7 smaller / regional plans	$254 - $3,939

Government programs also on file: Medicare, Medicaid.

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 3,014), 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 Sharp Coronado Hospital and Hlthcr Ctr 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 Sharp Coronado Hospital and Hlthcr Ctr

Compare: Upper endoscopy with biopsy at other CA hospitals

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