CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Providence Saint Joseph Medical Ctr
Billing Code: 43239 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$1,600
about 1.7× the $927 Medicare rate · typically $1,191–$2,556
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $1,600 Cash price $407 Hospital's list price $1,164
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✓ 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 | $2,654 - $3,006 | 286% |
| Blue Cross Blue Shieldmajor | $1,222 - $5,149 | 132% |
| Aetnamajor | $1,167 | 126% |
| Cignamajor | $3,452 | 373% |
| Humanamajor | $1,190 | 128% |
| Health Net | $2,158 - $4,385 | 233% |
| + 2 smaller / regional plans | $1,283 - $1,516 |
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Other Procedures at Providence Saint Joseph Medical Ctr
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.