Upper endoscopy with biopsy
Facility: Chapman Global Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $5,320
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.74x 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 574% of the Medicare baseline (a markup of 474%). 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 |
|---|---|---|
| Brand New Day | $281 - $6,651 | 30% |
| Healthcare Partners | $336 | 36% |
| Hollywood Presbyterian | $336 - $5,320 | 36% |
| Kaiser | $336 - $5,320 | 36% |
| Medi-Cal | $336 | 36% |
| Prime Health Services | $336 - $6,118 | 36% |
| State Of California | $336 | 36% |
| Altamed | $470 - $5,320 | 51% |
| Altamed Whole Child Model/Caloptima | $470 | 51% |
| Caloptima | $470 - $5,321 | 51% |
| Choc Health Alliance | $470 | 51% |
| County Of Orange | $470 - $6,651 | 51% |
| Family Choice | $470 | 51% |
| Heritage Provider Network | $470 - $5,320 | 51% |
| Monarch Health Plan | $470 - $4,525 | 51% |
| Prospect Health Plan | $470 - $7,981 | 51% |
| Ihhi | $1,200 | 130% |
| Coventry Health | $1,396 - $1,474 | 151% |
| Interplan | $1,412 | 152% |
| Multiplan | $1,520 | 164% |
| Three Rivers Wc | $1,520 | 164% |
| Indemnity Workers Comp California Fee Schedule | $1,551 | 167% |
| Velocity National Provider Network Wc | $1,551 | 167% |
| Aetna | $2,138 - $5,320 | 231% |
| UnitedHealthcare | $4,605 - $5,320 | 497% |
| Champ | $4,676 | 505% |
| Champus | $4,676 | 505% |
| Scan/Altamed | $5,054 | 545% |
| Altamed Health Services | $5,320 | 574% |
| Astiva | $5,320 | 574% |
| Blue Shield Of California | $5,320 - $20,270 | 574% |
| Central Health Plan | $5,320 | 574% |
| Champion Health Plan | $5,320 | 574% |
| Citizen Choice Health Plan | $5,320 | 574% |
| Clever Care | $5,320 | 574% |
| Easy Choice | $5,320 | 574% |
| For Your Benefit | $5,320 | 574% |
| Health Net | $5,320 - $9,172 | 574% |
| Healthcare Partners Sr Hmo | $5,320 | 574% |
| Humana | $5,320 | 574% |
| Medicare (plans) | $5,320 | 574% |
| Monarch Sr | $5,320 | 574% |
| Onecare | $5,320 | 574% |
| Onecare/Connect | $5,320 | 574% |
| Scan Health Plan | $5,320 | 574% |
| St Joseph | $5,320 | 574% |
| Us Federal Marshall/Department Of Immigration | $5,320 | 574% |
| Velocity National Provider Network Sr | $5,320 | 574% |
| Verda Health Plan | $5,320 | 574% |
| Veterans Administration | $5,320 | 574% |
| Apex Hospice | $5,321 | 574% |
| Choice Physicians Network | $5,321 | 574% |
| Imperial Health Plan Of Ca | $5,321 | 574% |
| Innovative Integrated Health | $5,321 | 574% |
| Medcare Partners Health Plan | $5,321 | 574% |
| Self Pay | $5,321 | 574% |
| Us Department Of Labor/Workers Comp | $5,321 | 574% |
| Victim Of Violent Crime | $5,321 | 574% |
| Victoria Hospice | $5,321 | 574% |
| Healthcare Partners Hmo | $5,746 | 620% |
| Cigna | $5,871 | 634% |
| Align Senior Care | $5,959 | 643% |
| Veterans Evaluation Services | $6,651 | 718% |
| Staywell/Island Home Ins | $7,449 | 804% |
| Three Rivers Network | $9,311 | 1005% |
| Velocity National Provider Network Ppo | $9,311 | 1005% |
| Multiplan/Master | $35,000 | 3777% |
| Healthsmart Preferred Network | $37,500 | 4047% |