CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Spanish Peaks Regional Health Center

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$414
about 0.4× the $927 Medicare rate · typically $145–$1,710
modeled estimate · not a bill or quote
What this hospital charges insurers
$495
Above the fair price
about $81 over the fair price · 0.5× Medicare
Medicare pays $927 Fair price $414 This hospital $495 Cash price $608 Hospital's list price $676

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 $495

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 $414 (about 0.4× the $927 Medicare rate). Spanish Peaks Regional Health Center charges insurers about $495, or about $608 in cash — above the fair price. Located in Walsenburg, 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 $414. 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✓ Cigna✓ Humana AetnaKaiser 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 $331 - $629 36%
Blue Cross Blue Shieldmajor $331 - $608 36%
Cignamajor $608 66%
Humanamajor $300 32%
Devoted Health $315 34%
+ 6 smaller / regional plans $608 - $1,381
Government programs also on file: Medicare.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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.

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Facility Profile & Credentials

  • Address: 23500 Us Highway 160, Walsenburg, CO 81089
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals