CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Parrish Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $2,267
  • Cash Discount Price: $1,813
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Parrish Medical Center is $2,267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,813. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 2.45x the Medicare baseline. Located in 951 N Washington Ave, Titusville, FL.
Cash / Self-Pay
$1,813

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,267

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: $1,813 (196%)
Insurance Median: $2,267 (245%)
Cash: $1,813 (196% of Medicare)
Ins. Median: $2,267 (245% 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 245% of the Medicare baseline (a markup of 145%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Florida Mhs Inc $373 40%
Medicaid / KanCare $373 - $649 40%
Simply Healthcare Plans $373 40%
UnitedHealthcare $392 - $3,128 42%
Florida Health Care Plan $471 51%
Webtpa $607 66%
Careplus Health Plans Inc. $626 68%
Aetna $649 - $3,037 70%
Freedom Health $649 - $932 70%
Healthease/Staywell Of Florida Inc $649 70%
Humana $649 - $2,266 70%
Sunshine State Health Plan $649 70%
Molina Healthcare Of Florida $675 73%
Florida Health Care Plan Commercial $680 - $2,742 73%
Veterans $710 77%
Blue Cross Blue Shield $791 - $3,524 85%
Health First Health Plans $932 - $4,533 101%
Medicare (plans) $932 101%
Cigna $947 - $3,173 102%
Tricare $947 102%
Auto $1,894 204%
Brevard County Commissioners $2,176 235%
Brevard School Board $2,176 235%
Pmc Hpi Employee Plan $2,357 254%
Pmc Preferred Benefit Administrators $2,357 254%
Corvel Healthcare Corporation $2,876 310%
Coventry Healthcare $4,080 440%
Coventry Helthcare Inc $4,080 440%
First Health Group Corp $4,080 440%
Beech Street Corporation $4,306 465%
Multiplan Inc $4,306 465%
Private Healthcare Systems Inc $4,306 465%
Early Steps $4,533 489%
No Contract $4,533 489%
Self Pay $4,533 489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 951 N Washington Ave, Titusville, FL 32796
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals