CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Nemours Children's Hospital, Delaware

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$588
about 0.6× the $927 Medicare rate · typically $211–$1,690
modeled estimate · not a bill or quote
What this hospital charges insurers
$630
About the fair price
about $42 over the fair price · 0.7× Medicare
Medicare pays $927 Fair price $588 This hospital $630 Cash price $4,812 Hospital's list price $4,812

How we calculate the fair BaseRate →

How this hospital compares to other DE hospitals

One of the lower prices — 4 of 6 other DE hospitals charge more for the same procedure.

Cheapest $360 Priciest $2,432

Black dot = this hospital, among the 7 DE hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $588 (about 0.6× the $927 Medicare rate). Nemours Children's Hospital, Delaware charges insurers about $630, or about $4,812 in cash — about the fair price. Located in Wilmington, DE.

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 $1,766 - $3,003 191%
Blue Cross Blue Shieldmajor $1,490 - $4,249 161%
Aetnamajor $2,041 - $2,791 220%
Cignamajor $2,647 - $3,032 286%
Ambetter (Centene) $2,743 296%
AmeriHealth $1,474 - $2,743 159%
Fidelis Care $1,925 208%
Geisinger $2,887 312%
HealthPartners $1,867 201%
UPMC Health Plan $1,906 206%
+ 14 smaller / regional plans $622 - $4,812
Government programs also on file: Military & VA.
Excludes 7 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens