Upper endoscopy with biopsy
Facility: Saint Joseph Hospital
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $4,533 compared to the $1,430 fair price benchmark.
5-Star CMS clinical quality rating paired with 3.17× fair market pricing.
Highest price of the 9 CO hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 CO hospitals with a price for this procedure. Full list below.
A fair price for a Upper endoscopy with biopsy is about $1,430 (about 1.5× the $927 Medicare rate). Saint Joseph Hospital charges insurers about $4,533 — well above the fair price. Located in Denver, CO.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $1,430. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
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
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 | $933 - $4,533 | 101% |
| Blue Cross Blue Shieldmajor | $4,667 | 504% |
| Aetnamajor | $5,981 - $6,503 | 645% |
| Cignamajor | $2,642 - $4,283 | 285% |
| Humanamajor | $2,993 | 323% |
| Kaiser Permanentemajor | $5,838 | 630% |
| GEHA | $4,533 - $6,503 | 489% |
| SelectHealth | $942 | 102% |
| + 2 smaller / regional plans | $2,450 - $6,503 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Saint Joseph Hospital
Compare: Upper endoscopy with biopsy at other CO hospitals
- Mercy Regional Medical Center · Durango $131
- Centura Health-St Anthony Hospital · Lakewood $131
- Centura Health-Penrose St Francis Health Services · Colorado Springs $131
- St Elizabeth Hospital · Fort Morgan $131
- Centura Health-St Anthony North Health Campus · Westminster $131
- St Anthony Summit Medical Center · Frisco $131
- Orthocolorado Hosp at St Anthony Med Campus · Lakewood $131
- St Francis Hospital - Interquest · Colorado Springs $131
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Saint Joseph Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,949
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $3,949).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Saint Joseph Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $1,430 Fair BaseRate ($927 Medicare)
Your bill ($10,879) is $9,449 above the denoised Fair BaseRate ($1,430) and 11.7× the $927 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.