CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Cobalt Rehabilitation Hospital Denver LLC

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $2,851
Cash Discount Price: $3,801
vs. Medicare Baseline: 3.08x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Cobalt Rehabilitation Hospital Denver LLC is $2,851. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,801. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 3.08x the Medicare baseline. Located in 6500 W 104Th Ave, Westminster, CO.

Cash / Self-Pay

$3,801

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,851

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: $3,801 (410%)

Insurance Median: $2,851 (308%)

Cash: $3,801 (410% of Medicare)

Ins. Median: $2,851 (308% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 308% of the Medicare baseline (a markup of 208%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
America'S Choice Provider Network	$2,661	287%
Quik Trip	$2,851	308%
Usa Managed Care Organization	$2,851	308%
Velocity Provider Ppo Network	$2,851	308%
Multiplan/Phcs	$3,041	328%
Prime Health Services	$3,231	349%

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 $3,801.
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 Cobalt Rehabilitation Hospital Denver LLC 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.