Upper endoscopy with biopsy
Facility: Anaheim Global Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $4,645
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.01x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 501% of the Medicare baseline (a markup of 401%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medi-Cal Hmo/Non Contract | $234 | 25% |
| Brand New Day | $281 - $5,807 | 30% |
| Healthcare Partners | $336 | 36% |
| Hollywood Presbyterian | $336 | 36% |
| Kaiser | $336 - $4,645 | 36% |
| Prime Health Services | $336 - $5,342 | 36% |
| State Of California | $336 - $1,551 | 36% |
| Altamed | $470 - $4,645 | 51% |
| Caloptima | $470 - $4,646 | 51% |
| Choc Health Alliance | $470 | 51% |
| County Of Orange | $470 - $5,806 | 51% |
| Family Choice Mcal | $470 | 51% |
| Heritage Provider Network | $470 - $4,645 | 51% |
| Prospect Health Plan | $470 - $6,969 | 51% |
| Ihhi Reciprocity | $1,200 | 130% |
| Coventry Health | $1,396 - $1,451 | 151% |
| Interplan | $1,412 | 152% |
| Multiplan | $1,520 - $35,000 | 164% |
| Three Rivers Network | $1,520 - $8,130 | 164% |
| Velocity National Provider Network Wc | $1,551 | 167% |
| Aetna | $2,138 - $4,645 | 231% |
| Monarch Health Plan | $3,591 - $4,519 | 388% |
| Altamed Health Services | $4,413 - $4,645 | 476% |
| UnitedHealthcare | $4,605 - $4,764 | 497% |
| Astiva | $4,645 | 501% |
| Blue Shield Of California | $4,645 - $17,698 | 501% |
| California Health Plan | $4,645 | 501% |
| Central Health Plan Of California Inc | $4,645 | 501% |
| Champion Health Plan | $4,645 | 501% |
| Citizens Choice | $4,645 | 501% |
| Clever Care Health Plan | $4,645 | 501% |
| Easy Choice | $4,645 | 501% |
| For Your Benefit | $4,645 | 501% |
| Health Net Inc | $4,645 | 501% |
| Healthcare Partners Sr Hmo | $4,645 | 501% |
| Hollywood Presbyerian | $4,645 | 501% |
| Humana | $4,645 | 501% |
| Medicare (plans) | $4,645 | 501% |
| Monarch | $4,645 | 501% |
| Onecare | $4,645 | 501% |
| Other Sr Non Contract | $4,645 | 501% |
| Physicians For Healthy Hospitals | $4,645 | 501% |
| Scan | $4,645 | 501% |
| St Joseph Hospital Sr | $4,645 | 501% |
| Us Federal Marshall/Department Of Immigration | $4,645 | 501% |
| Velocity National Provider Network Sr | $4,645 | 501% |
| Verda Health Plan | $4,645 | 501% |
| Veterans Administration | $4,645 | 501% |
| Choice Physicians Network | $4,646 | 501% |
| Imperial Health Plan Of Ca | $4,646 | 501% |
| Innovative Integrated Health | $4,646 | 501% |
| Medcare Partners Health Plan | $4,646 | 501% |
| Self Pay/Ab774/Cbo Use Only | $4,646 | 501% |
| Us Dept Of Labor | $4,646 | 501% |
| Victim Of Violent Crime | $4,646 | 501% |
| Victim Of Violent Crime (Mep) | $4,646 | 501% |
| Victoria Hospice | $4,646 | 501% |
| Champus | $4,676 | 505% |
| Healthcare Partners Hmo | $5,017 | 541% |
| Align Sr Care | $5,203 | 561% |
| Veterans Evaluation Services | $5,807 | 627% |
| Cigna | $5,871 | 634% |
| Staywell/Island Home Ins | $6,504 | 702% |
| Health Net | $6,551 - $8,008 | 707% |
| Naphcare | $7,201 | 777% |
| Velocity National Provider Network Ppo | $8,130 | 877% |
| Healthsmart Preferred Network | $37,500 | 4047% |