Upper endoscopy with biopsy
Facility: Hialeah Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $922
- Cash Discount Price: $2,592
- vs. Medicare Baseline: 1.00x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Oscar Health Plan Hix | $159 | 17% |
| Aetna | $177 - $1,866 | 19% |
| Imagine Health | $259 | 28% |
| UnitedHealthcare | $283 - $908 | 31% |
| Healthsun Health Plans | $391 - $953 | 42% |
| Cigna | $451 - $953 | 49% |
| Self Pay/Uninsured | $466 - $1,134 | 50% |
| Employer Direct Healthcare | $473 - $922 | 51% |
| Avmed Broad Network | $544 | 59% |
| Veterans Administration Mill Bill | $635 | 69% |
| Humana | $645 - $1,187 | 70% |
| Medicaid / KanCare | $645 - $677 | 70% |
| Medicare (plans) | $817 - $1,983 | 88% |
| Leon Health Inc | $904 | 98% |
| Devoted Health | $908 | 98% |
| Tricare | $913 | 99% |
| Bristol Hospice- Miami Dade Llc | $922 | 100% |
| Catholic Hospice | $922 | 100% |
| Comprehensive Home Health Care Dba Opuscare Of South Florida | $922 | 100% |
| Hcr Manor Care Services Of Fl | $922 | 100% |
| Hospice Other | $922 | 100% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $922 | 100% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $922 | 100% |
| Veterans Administration Vaccn | $922 | 100% |
| Vitas Healthcare Hospice Corporation Of Fl | $922 | 100% |
| Vitas Hospice Unit Agreement | $922 | 100% |
| Longevity Health Plan | $964 | 104% |
| Florida Pace Centers | $1,089 | 118% |
| Bright Health Management Commercial | $1,107 | 119% |
| Naphcare Inc | $1,271 | 137% |
| Bc/Bs Of Fl Phs | $1,344 | 145% |
| Avmed Exchange | $1,614 | 174% |
| Bc/Bs Of Fl Miami Dade Blue Select | $1,634 | 176% |
| Dimensions International | $1,685 | 182% |
| Ambetter / Centene | $1,706 | 184% |
| Molina Marketplace Program Exchange | $1,757 | 190% |
| First Health | $1,762 | 190% |
| Auto Insurance | $1,845 | 199% |
| Avmed Select Network | $1,888 | 204% |
| Dimension Health Ppo | $1,944 | 210% |
| Dimension Health Wc | $1,944 | 210% |
| Workers Compensation | $1,944 | 210% |
| Amerihealth Caritas Next Exchange | $1,983 | 214% |
| Bc/Bs Of Fl Health Options Hmo | $2,022 | 218% |
| Bc/Bs Of Fl Network Blue | $2,092 | 226% |
| Bc/Bs Myblue Hmo Hix | $2,153 | 232% |
| Bc/Bs Of Fl Simplyblue | $2,266 | 245% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $2,302 | 248% |
| Commercial Non-Contracted | $2,592 | 280% |
| Self Pay - Mcd Pending 100 Percent | $2,592 | 280% |
| Single Case Agreement | $2,592 | 280% |
| Bc/Bs Of Fl Ppo | $2,899 | 313% |