CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: HCA Healthone Mountain Ridge

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$1,520

about 1.6× the $927 Medicare rate · typically $204–$3,240

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,716

Well above the fair price

about $1,196 over the fair price · 2.9× Medicare

Medicare pays $927 Fair price $1,520 This hospital $2,716

How we calculate the fair BaseRate →

How this hospital compares to other CO hospitals

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

Cheapest $131 Priciest $2,716

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 $1,520 (about 1.6× the $927 Medicare rate). HCA Healthone Mountain Ridge charges insurers about $2,716 — well above the fair price. Located in Thornton, 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 $1,520. 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.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$3,090 - $5,268	333%
Blue Cross Blue Shieldmajor	$2,125 - $4,764	229%
Aetnamajor	$4,063 - $6,158	438%
Cignamajor	$944 - $2,651	102%
+ 1 smaller / regional plan	$5,268

Excludes 2 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 HCA Healthone Mountain Ridge 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 HCA Healthone Mountain Ridge

Compare: Upper endoscopy with biopsy at other CO hospitals

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