CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Orange County Global Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,325

about 1.4× the $927 Medicare rate · typically $747–$2,811

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,164

Below the fair price — a good deal

about $161 under the fair price · 1.3× Medicare

Medicare pays $927 Fair price $1,325 This hospital $1,164

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $125 Priciest $1,164

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,325 (about 1.4× the $927 Medicare rate). Orange County Global Medical Center charges insurers about $1,164 — below the fair price — a good deal. Located in Santa Ana, CA.

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	$1,161 - $4,764	125%
Blue Cross Blue Shieldmajor	$1,161 - $4,423	125%
Aetnamajor	$1,161 - $2,138	125%
Cignamajor	$5,871	634%
Humanamajor	$1,161	125%
Kaiser Permanentemajor	$336 - $1,161	36%
Health Net	$1,161 - $6,092	125%
Presbyterian	$336 - $1,161	36%
Sentara	$470 - $1,167	51%
+ 47 smaller / regional plans	$281 - $4,487

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 10 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, 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 Orange County Global Medical Center 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 Orange County Global Medical Center

Compare: Upper endoscopy with biopsy at other CA hospitals

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