CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Aspen Valley Hospital
Billing Code: 43239 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 43239
- Insurance Median: $1,646
- Cash Discount Price: $1,646
- vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Aspen Valley Hospital is $1,646. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,646. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.78x the Medicare baseline. Located in 401 Castle Creek Rd, Aspen, CO.
Cash / Self-Pay
$1,646
Average discount available for prompt cash payment at this facility.
Insurance Median
$1,646
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: $1,646 (178%)
Insurance Median: $1,646 (178%)
Cash: $1,646 (178% of Medicare)
Ins. Median: $1,646 (178% 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.
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 |
|---|---|---|
| Aetna | $889 - $1,646 | 96% |
| Humana | $889 - $1,564 | 96% |
| Medicare (plans) | $889 | 96% |
| Tricare | $889 - $1,646 | 96% |
| UnitedHealthcare | $889 - $1,646 | 96% |
| Veterans Administration [100068] | $889 | 96% |
| Cigna | $1,152 - $1,646 | 124% |
| Blue Cross Blue Shield | $1,292 - $1,523 | 139% |
| Allied Benefit Systems [100015] | $1,564 | 169% |
| Geha [100039] | $1,564 | 169% |
| Healthscope [100157] | $1,564 | 169% |
| Ccmsi [700017] | $1,619 | 175% |
| Aarp [100007] | $1,646 | 178% |
| Aig Travel [100255] | $1,646 | 178% |
| Aig [700029] | $1,646 | 178% |
| Ameriben [100266] | $1,646 | 178% |
| American Republic [100018] | $1,646 | 178% |
| Amtrust North America [700042] | $1,646 | 178% |
| Axa Travel [100256] | $1,646 | 178% |
| Bankers Life Casualty [100022] | $1,646 | 178% |
| Broadspire [700043] | $1,646 | 178% |
| Bupa Global [100257] | $1,646 | 178% |
| Champ Va [500001] | $1,646 | 178% |
| Chp [300053] | $1,646 | 178% |
| Chubb Services [700054] | $1,646 | 178% |
| Companion Life Pivot Health [100258] | $1,646 | 178% |
| Corvel [700058] | $1,646 | 178% |
| Employee Benefit Management [100033] | $1,646 | 178% |
| Equitable Life [100160] | $1,646 | 178% |
| Esis Work Comp [700010] | $1,646 | 178% |
| Freedom Life Insurance Company [100158] | $1,646 | 178% |
| Gallagher Bassett Work Comp [700013] | $1,646 | 178% |
| Generic Commercial [109999] | $1,646 | 178% |
| Generic Other [509999] | $1,646 | 178% |
| Generic Travel Insurance [109998] | $1,646 | 178% |
| Generic Workers' Comp [709999] | $1,646 | 178% |
| Gerber Life Insurance [100265] | $1,646 | 178% |
| Global Excel [100259] | $1,646 | 178% |
| Gmmi [100260] | $1,646 | 178% |
| Hartford Work Comp [700055] | $1,646 | 178% |
| Harvard Pilgrim Healthcare [100241] | $1,646 | 178% |
| Health Net [100261] | $1,646 | 178% |
| Imagine 360 [100043] | $1,646 | 178% |
| Kaiser Permanente [100254] | $1,646 | 178% |
| Liberty Healthshare [100262] | $1,646 | 178% |
| Liberty Mutual Work Comp [700016] | $1,646 | 178% |
| Marriott Claim [700056] | $1,646 | 178% |
| Medi Share [100263] | $1,646 | 178% |
| Medicaid / KanCare | $1,646 | 178% |
| Mutual Of Omaha [100074] | $1,646 | 178% |
| Owcp [700057] | $1,646 | 178% |
| Physicians Mutual [100075] | $1,646 | 178% |
| Pinnacol Assurance Wc [700059] | $1,646 | 178% |
| Relations Insurance Kaiser [800004] | $1,646 | 178% |
| Sedgwick [700027] | $1,646 | 178% |
| Sentinel Security Life [100264] | $1,646 | 178% |
| Skico Ortho Alternative Payer [100163] | $1,646 | 178% |
| Transamerica [100097] | $1,646 | 178% |
| Travelers Work Comp [700028] | $1,646 | 178% |
| Tufts Health Plan [100268] | $1,646 | 178% |
| United American Insurance [100119] | $1,646 | 178% |
| Usaa Life Insurance Company [100155] | $1,646 | 178% |
| Wea [100120] | $1,646 | 178% |