CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Uch-Memorial Health System

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $1,526
Cash Discount Price: $1,551
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Uch-Memorial Health System is $1,526. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,551. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.65x the Medicare baseline. Located in 1400 E Boulder St, Colorado Springs, CO.

Cash / Self-Pay

$1,551

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,526

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)

Cash / Self-Pay: $1,551 (167%)

Insurance Median: $1,526 (165%)

Cash: $1,551 (167% of Medicare)

Ins. Median: $1,526 (165% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Blue Cross Blue Shield	$728 - $3,452	79%
Kaiser Public Option	$797 - $3,436	86%
Select Health	$874 - $2,348	94%
Aetna	$942 - $6,680	102%
Cigna	$942 - $1,703	102%
Cms	$942	102%
Devoted Health	$942	102%
Humana	$942	102%
Kaiser	$942 - $6,191	102%
UnitedHealthcare	$942 - $4,872	102%
Kaiser Kp Select	$1,049 - $5,077	113%
Simplified Benefits Administration	$1,106 - $1,344	119%
Denver Health Medical Plan	$1,724	186%
Rocky Mountain Health Plan	$1,861	201%
First Health	$2,034	220%
Multiplan	$2,447	264%
Phcs	$2,447	264%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,551.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Uch-Memorial Health System is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.