CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Holy Cross Hospital
Billing Code: 43239 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 43239
- Insurance Median: $67
- Cash Discount Price: $517
- vs. Medicare Baseline: 0.07x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Holy Cross Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $517. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.07x the Medicare baseline. Located in 4725 N Federal Hwy, Ft Lauderdale, FL.
Cash / Self-Pay
$517
Average discount available for prompt cash payment at this facility.
Insurance Median
$67
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: $517 (56%)
Insurance Median: $67 (7%)
Cash: $517 (56% of Medicare)
Ins. Median: $67 (7% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $44 - $99 | 5% |
| Aetna | $52 - $928 | 6% |
| Albany County Correctional Facility | $52 | 6% |
| Ambetter / Centene | $52 - $1,656 | 6% |
| Amish Mennonite | $52 | 6% |
| Ascension St. Vincent Public Safety Medical | $52 | 6% |
| Bcccp-Michigan | $52 | 6% |
| Bccp | $52 | 6% |
| Blue Cross Blue Shield | $52 - $10,114 | 6% |
| Bmc Healthnet | $52 | 6% |
| Breast Grant-Connecticut | $52 | 6% |
| Broward County Dept Of Health | $52 | 6% |
| California Health And Wellness | $52 | 6% |
| Cardinal Innovations Lme | $52 | 6% |
| Care Connections Of Northern Iowa | $52 | 6% |
| Care Oregon Ohp | $52 | 6% |
| Cencal Health Plan | $52 | 6% |
| Cenpatico | $52 | 6% |
| Chhuny | $52 | 6% |
| Childrens Comm Health Plan | $52 | 6% |
| Childrens Medical Services Title 19 | $52 | 6% |
| Cigna | $52 - $956 | 6% |
| City Of Philadelphia | $52 | 6% |
| Cmh Allegan County | $52 | 6% |
| Cmh Ausable Valley | $52 | 6% |
| Cmh Barry County | $52 | 6% |
| Cmh Bay-Arenac County | $52 | 6% |
| Cmh Berrien County | $52 | 6% |
| Cmh Cass County | $52 | 6% |
| Cmh Central Mi County | $52 | 6% |
| Cmh Clinton-Eaton-Ingham County | $52 | 6% |
| Cmh Detroit Wayne Integrated Health Network | $52 | 6% |
| Cmh Genesee County | $52 | 6% |
| Cmh Ionia County | $52 | 6% |
| Cmh Jackson County/Lifeways | $52 | 6% |
| Cmh Kalamazoo | $52 | 6% |
| Cmh Kent County | $52 | 6% |
| Cmh Lenawee County | $52 | 6% |
| Cmh Livingston County | $52 | 6% |
| Cmh Macomb | $52 | 6% |
| Cmh Misc | $52 | 6% |
| Cmh Monroe County | $52 | 6% |
| Cmh Montcalm County | $52 | 6% |
| Cmh Muskegon County | $52 | 6% |
| Cmh Newaygo County | $52 | 6% |
| Cmh North Country | $52 | 6% |
| Cmh Northern Lakes County | $52 | 6% |
| Cmh Oakland County | $52 | 6% |
| Cmh Ottawa County | $52 | 6% |
| Cmh Van Buren County | $52 | 6% |
| Cmh Washtenaw County | $52 | 6% |
| Cmh Wayne County/Carelink | $52 | 6% |
| Cmh Wayne Cty/Com Liv Svcs | $52 | 6% |
| Cmh West Mi County | $52 | 6% |
| Community Benefit Health | $52 | 6% |
| Community Care Behavorial Health | $52 | 6% |
| Community Care Partners | $52 | 6% |
| Community Health Choice | $52 | 6% |
| Connections Csp | $52 | 6% |
| County Coroner | $52 | 6% |
| County Funding Generic | $52 | 6% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $52 | 6% |
| Dean Wi Badgercare | $52 | 6% |
| Delaware County Department Of Health | $52 | 6% |
| Delaware First Health | $52 | 6% |
| Delta Dental Nj | $52 | 6% |
| Dph Tb Program | $52 | 6% |
| Dscc | $52 | 6% |
| Eastpointe Lme | $52 | 6% |
| Family Health Network | $52 | 6% |
| Freedom First Healthcare | $52 | 6% |
| Fresno County Ccs | $52 | 6% |
| Ghc Scw Wi Badgercare | $52 | 6% |
| Harbor Health | $52 | 6% |
| Health Safety Net | $52 | 6% |
| Healthy Blue Ne | $52 | 6% |
| Hennepin Health | $52 | 6% |
| Humana | $52 - $1,522 | 6% |
| Id County Ada | $52 | 6% |
| Id County Canyon | $52 | 6% |
| Id County Cat Fund | $52 | 6% |
| Id County Other | $52 | 6% |
| Id County Payette | $52 | 6% |
| Idaho Dept Health And Wellfare | $52 | 6% |
| Idaho Womens Health Check | $52 | 6% |
| Indiana Breast Cervical Cancer | $52 | 6% |
| Inland Empire Health Plan | $52 | 6% |
| Intercommunity Health Ohp | $52 | 6% |
| Iowa Total Care | $52 | 6% |
| Jai Medical System | $52 | 6% |
| Kern Family Health Plan | $52 | 6% |
| Keystone First | $52 | 6% |
| Keystone First Chip | $52 | 6% |
| La Care Health Plan | $52 | 6% |
| Lakeland Care Inc | $52 | 6% |
| Managed Health Services - Indiana | $52 | 6% |
| Maryland Breast & Cervical Program | $52 | 6% |
| Maryland Healthy Smiles - Scion Dental | $52 | 6% |
| Maryland Physicians Care | $52 | 6% |
| Massachusetts Behavioral Health Partnership | $52 | 6% |
| Mdwise | $52 | 6% |
| Medi-Cal | $52 | 6% |
| Medi-Cal Healthnet | $52 | 6% |
| Medstar Dc Healthy Family | $52 | 6% |
| Medstar Md Health Choice | $52 | 6% |
| Mo Home State Health Plan | $52 | 6% |
| Molina Centennial Care | $52 | 6% |
| Nascentia Health Options | $52 | 6% |
| Nebraska Total Care | $52 | 6% |
| New York Cancer Services Program | $52 | 6% |
| Nextlevel Health | $52 | 6% |
| Oregon Screenwise | $52 | 6% |
| Pace Of Southwest Michigan | $52 - $64 | 6% |
| Paramount Advantage | $52 | 6% |
| Parkland Community Health Plan | $52 | 6% |
| Partners Behavioral Lme | $52 | 6% |
| Peach State Healthplan | $52 | 6% |
| Philadelphia County Funding | $52 | 6% |
| Presbyterian Centennial Care | $52 | 6% |
| Prestige Health Choice | $52 | 6% |
| Priority Partners | $52 | 6% |
| Robert F Sing Program | $52 | 6% |
| Rx 340B Pass Along | $52 | 6% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $52 | 6% |
| Rx Medi-Cal | $52 | 6% |
| Rx Meridian Rx | $52 | 6% |
| Ryan White Florida Mssrp | $52 - $947 | 6% |
| Sandhills Center Lme | $52 | 6% |
| Screening For Life | $52 | 6% |
| St Joseph County Hlth Dpt | $52 | 6% |
| Stephenson Cty Health | $52 | 6% |
| Superior Health | $52 | 6% |
| Tenncare | $52 | 6% |
| Texas Children'S Health Plan | $52 | 6% |
| Trillium Community Ohp | $52 | 6% |
| Tufts Health Public Plans | $52 | 6% |
| UnitedHealthcare | $52 - $2,582 | 6% |
| Vaya Health Lme | $52 | 6% |
| Washtenaw Health Plan | $52 | 6% |
| Wellsense Health Plan | $52 | 6% |
| Wi Womens Wellness | $52 | 6% |
| Sunshine State Health Plan | $54 - $55 | 6% |
| Preferred Care Partners | $58 - $928 | 6% |
| Align Senior Care | $64 | 7% |
| Ally Align Care Adv | $64 | 7% |
| American Health Advantage Of Idaho | $64 | 7% |
| American Health Plan | $64 | 7% |
| Aurora Special Needs | $64 | 7% |
| Blue Care Network Advantage | $64 | 7% |
| Blue Shield - De (Highmark) Medciare Advantage | $64 | 7% |
| Care Dimensions | $64 | 7% |
| Care Improvement Plus | $64 | 7% |
| Care Resources Pace | $64 | 7% |
| Careplus Health Plans | $64 - $950 | 7% |
| Cca - Zing Health | $64 | 7% |
| Cca Senior Care Options | $64 | 7% |
| Central Valley Medical Services Corp Pace | $64 | 7% |
| Champion Health Plan Mcr Advantage | $64 | 7% |
| Clear Spring Health | $64 | 7% |
| Clover Health | $64 | 7% |
| Commonwealth Care Alliance | $64 | 7% |
| Community Pace At Home | $64 | 7% |
| Eddy Senior Care-Pace | $64 | 7% |
| Eddy Seniorcare Pace | $64 | 7% |
| Elementcare | $64 | 7% |
| Evercare | $64 | 7% |
| Everence | $64 | 7% |
| Gateway Health Plan | $64 | 7% |
| Genesys Pace Of Genesee County | $64 | 7% |
| Georgia Health Advantage | $64 | 7% |
| Gold Advantage | $64 | 7% |
| Gpa Croell Redi Mix | $64 | 7% |
| Health America Advantra | $64 | 7% |
| Highmark Health Options Dual Plan | $64 | 7% |
| Hope Select Pace | $64 | 7% |
| Horizon Nj Total Care | $64 | 7% |
| Hudson Headwaters Pace | $64 | 7% |
| Huron Valley Pace | $64 | 7% |
| Innovative Integrated Health Community Plans | $64 | 7% |
| Iowa Health Advantage | $64 | 7% |
| Johns Hopkins Advantage Md | $64 | 7% |
| Lasso Healthcare Msa | $64 | 7% |
| Life St Marys Pace | $64 | 7% |
| Lifecircles Pace | $64 | 7% |
| Longevity Health Plan | $64 | 7% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $64 | 7% |
| Martins Point Generations Advantage | $64 | 7% |
| Mass General Brigham Mcr Adv | $64 | 7% |
| Medicare (plans) | $64 - $994 | 7% |
| Medipak Advantage | $64 | 7% |
| Mercy Life | $64 | 7% |
| Mercyone Cedar Valley | $64 | 7% |
| Meridian Complete | $64 | 7% |
| Michigan Complete Health | $64 | 7% |
| Nascentia Health Plus | $64 | 7% |
| Osu Prime Care Advantage | $64 | 7% |
| Pace Cny | $64 | 7% |
| Pace Iowa Immanuel Pathways | $64 | 7% |
| Pace Southeast | $64 | 7% |
| Pace-Trinity Health | $64 | 7% |
| Peak Pace Solutions | $64 | 7% |
| Perennial Advantage | $64 | 7% |
| Presbyterian Senior Plan | $64 | 7% |
| Provider Partners Health Plan Of Illinois | $64 | 7% |
| Provider Partners Health Plan Of Indiana | $64 | 7% |
| Pruitthealth Premier | $64 | 7% |
| Reliance Community Care Partners Care Resources Pace | $64 | 7% |
| Rx Allwin | $64 | 7% |
| Rx Grane Grnmedd | $64 | 7% |
| Rx Retiree Rx Care | $64 | 7% |
| Scan Health Plan Mcr Ipa Meritage Oon | $64 | 7% |
| Secure Horizons Ma Pffs | $64 | 7% |
| Serenity Pace | $64 | 7% |
| Siouxland Pace | $64 | 7% |
| Sunnyview-Pace Finance Dept | $64 | 7% |
| Texan Plus | $64 | 7% |
| The Health Plan | $64 | 7% |
| Thome Pace | $64 | 7% |
| Todays Options | $64 | 7% |
| Tribute Health Plans | $64 | 7% |
| Um Health Advantage | $64 | 7% |
| Union Health Service | $64 | 7% |
| Welbe Health | $64 | 7% |
| Wellmed | $64 | 7% |
| New Centry Health Careplus | $66 | 7% |
| Veterans Administration | $66 | 7% |
| Champva | $67 | 7% |
| Tricare | $67 | 7% |
| Triwest Health Alliance | $67 | 7% |
| Us Family Health Plan | $67 | 7% |
| Veterans Eval Services | $67 | 7% |
| Solis Health Plans | $68 - $994 | 7% |
| Molina Marketplace | $79 - $1,367 | 9% |
| Oscar | $85 - $1,610 | 9% |
| Geha | $91 - $2,582 | 10% |
| Centivo | $92 - $2,036 | 10% |
| Curative | $92 - $1,752 | 10% |
| Multiplan | $99 - $362 | 11% |
| Phcs | $99 | 11% |
| Community Care Plan | $106 - $182 | 11% |
| Memorial Integrated Health | $106 - $182 | 11% |
| Coventry | $108 | 12% |
| First Health | $108 | 12% |
| Meritain | $108 | 12% |
| Avmed Health Plan | $113 - $2,544 | 12% |
| Bcn Domestic | $126 - $7,541 | 14% |
| Blue Benefit Administrators Of Massachusetts | $126 - $7,541 | 14% |
| Blue Care Network | $126 - $7,541 | 14% |
| Blue Distinction Transplant | $126 - $7,541 | 14% |
| Blue Shield - Ca | $126 - $7,541 | 14% |
| Blue Shield - Id (Regence) | $126 - $7,541 | 14% |
| Blue Shield - Ny Highmark Northeastern | $126 - $7,541 | 14% |
| Blue Shield - Ny Highmark Western | $126 - $7,541 | 14% |
| Blue Shield - Pa (Highmark) | $126 - $7,541 | 14% |
| Blue Shield - Wa (Regence) | $126 - $7,541 | 14% |
| Health Choices | $126 - $7,541 | 14% |
| Kaiser Domestic | $126 - $7,541 | 14% |
| Pre-Employment | $126 - $7,541 | 14% |
| Wc Domestic | $126 - $7,541 | 14% |
| Wc Broward County | $144 - $1,557 | 16% |
| Wc Corvel | $144 - $1,557 | 16% |
| Wc Heritage Summit | $147 - $1,589 | 16% |
| Andrie Inc | $152 | 16% |
| East Greenbush Central School District | $152 | 16% |
| Genex Wc | $152 | 16% |
| Healthsmart Workers Comp | $152 | 16% |
| Jag Source | $152 | 16% |
| New York State Insurance Fund | $152 | 16% |
| Njm Insurance Group | $152 | 16% |
| Rx Heatlhcomp | $152 | 16% |
| Rx Restat | $152 | 16% |
| Rx Saif Opdp Wc | $152 | 16% |
| Rx Worker'S Comp | $152 | 16% |
| Wc Accident Fund | $152 | 16% |
| Wc Ace | $152 | 16% |
| Wc Acs Federal Employees | $152 | 16% |
| Wc Acuity | $152 | 16% |
| Wc Advantage | $152 | 16% |
| Wc Aegis | $152 | 16% |
| Wc Aig | $152 | 16% |
| Wc Aims | $152 | 16% |
| Wc Alaska National Ins | $152 | 16% |
| Wc Align Network | $152 | 16% |
| Wc Allied | $152 | 16% |
| Wc Am Trust N America | $152 | 16% |
| Wc American Claims Mgmt | $152 | 16% |
| Wc Amerisure | $152 | 16% |
| Wc Amtrust | $152 | 16% |
| Wc Asu Risk Mgt | $152 | 16% |
| Wc Benetech | $152 | 16% |
| Wc Berkley Admin | $152 | 16% |
| Wc Broadspire | $152 | 16% |
| Wc Bunch & Associates | $152 | 16% |
| Wc California State Comp Ins | $152 | 16% |
| Wc California State Ins Fund | $152 | 16% |
| Wc Capitol Area Health Consortium | $152 | 16% |
| Wc Ccmsi | $152 | 16% |
| Wc Chartis | $152 | 16% |
| Wc Chubb | $152 | 16% |
| Wc Cirma | $152 | 16% |
| Wc City Of Albany | $152 | 16% |
| Wc City Of Sioux City | $152 | 16% |
| Wc Claims Mgmt Inc | $152 | 16% |
| Wc Cna | $152 | 16% |
| Wc Comp One Admin C/O Manageability | $152 | 16% |
| Wc Compone Admin | $152 | 16% |
| Wc Ct Healthcare Trust | $152 | 16% |
| Wc Donegal Insurance Group | $152 | 16% |
| Wc Emc Insurance Company | $152 | 16% |
| Wc Employee Mutual | $152 | 16% |
| Wc Enablecomp | $152 | 16% |
| Wc Encore Health Network | $152 | 16% |
| Wc Erie | $152 | 16% |
| Wc Esis | $152 | 16% |
| Wc Evolutions | $152 | 16% |
| Wc Fcci | $152 | 16% |
| Wc Fed Ex | $152 | 16% |
| Wc Federal Black Lung | $152 | 16% |
| Wc Federated | $152 | 16% |
| Wc Finley Occupational Health | $152 | 16% |
| Wc First Agency/Occunet | $152 | 16% |
| Wc Ford Motor | $152 | 16% |
| Wc Fresno Unified Emp | $152 | 16% |
| Wc Gallagher Bassett | $152 | 16% |
| Wc General Motors | $152 | 16% |
| Wc Generic | $152 | 16% |
| Wc Genex Care For Ohio | $152 | 16% |
| Wc Great West Casualty | $152 | 16% |
| Wc Guarantee Insurance | $152 | 16% |
| Wc Guard Insurance Company | $152 | 16% |
| Wc Hab | $152 | 16% |
| Wc Hartford | $152 | 16% |
| Wc Hastings | $152 | 16% |
| Wc Health Management | $152 | 16% |
| Wc Hireright | $152 | 16% |
| Wc Horizon | $152 | 16% |
| Wc Icw Group | $152 | 16% |
| Wc Idaho State Ins Fund | $152 | 16% |
| Wc Intercare Insurance | $152 | 16% |
| Wc Intermountain | $152 | 16% |
| Wc Johns Eastern | $152 | 16% |
| Wc Kemberton | $152 | 16% |
| Wc Key Ins & Benefit Solutions | $152 | 16% |
| Wc Liberty Mutual | $152 | 16% |
| Wc Mac Risk Management | $152 | 16% |
| Wc Massachusetts | $152 | 16% |
| Wc Mdia | $152 | 16% |
| Wc Meadowbrook Claim | $152 | 16% |
| Wc Medical Administrators | $152 | 16% |
| Wc Meijers | $152 | 16% |
| Wc Memic | $152 | 16% |
| Wc Mercy Workcare | $152 | 16% |
| Wc Michigan | $152 | 16% |
| Wc Michigan Millers Mutual | $152 | 16% |
| Wc Mitchell Frankenmuth | $152 | 16% |
| Wc Mra | $152 | 16% |
| Wc Nationwide | $152 | 16% |
| Wc Nca Comp | $152 | 16% |
| Wc New York | $152 | 16% |
| Wc New York Special Funds | $152 | 16% |
| Wc North American Rishces | $152 | 16% |
| Wc Northeast Health | $152 | 16% |
| Wc Notre Dame | $152 | 16% |
| Wc Novanet | $152 | 16% |
| Wc O'Hara Corp | $152 | 16% |
| Wc Occ Health Allen | $152 | 16% |
| Wc Ohio Bureau | $152 | 16% |
| Wc One Call Medical | $152 | 16% |
| Wc Paradigm | $152 | 16% |
| Wc Peerless | $152 | 16% |
| Wc Pma | $152 | 16% |
| Wc Price Chopper | $152 | 16% |
| Wc Procura Management | $152 | 16% |
| Wc Qualcare | $152 | 16% |
| Wc Quiktrip | $152 | 16% |
| Wc Reny Company | $152 | 16% |
| Wc Rev Claims | $152 | 16% |
| Wc Risico | $152 | 16% |
| Wc Rural Mutual | $152 | 16% |
| Wc Saif Oregon | $152 | 16% |
| Wc Secura | $152 | 16% |
| Wc Sedgwick | $152 | 16% |
| Wc Sentry | $152 | 16% |
| Wc Sheakley Unicomp | $152 | 16% |
| Wc Smile Lodge | $152 | 16% |
| Wc Society | $152 | 16% |
| Wc Srs | $152 | 16% |
| Wc Taconic (Mro) | $152 | 16% |
| Wc Taconic Farms | $152 | 16% |
| Wc Travelers | $152 | 16% |
| Wc Triad Group | $152 | 16% |
| Wc Tristar | $152 | 16% |
| Wc Troy Ny | $152 | 16% |
| Wc Tyson | $152 | 16% |
| Wc Unified Health Services | $152 | 16% |
| Wc United Heartland | $152 | 16% |
| Wc Us Dept Of Labor | $152 | 16% |
| Wc Velocity | $152 | 16% |
| Wc Walmart | $152 | 16% |
| Wc West Bend | $152 | 16% |
| Wc West Bend Mutual/Argent | $152 | 16% |
| Wc Winnebago Industries | $152 | 16% |
| Wc Yankee Trails | $152 | 16% |
| Wc York Risk | $152 | 16% |
| Wc Zenith | $152 | 16% |
| Wc Zurich | $152 | 16% |
| Upmc Health Plan | $207 | 22% |
| Allianz Global Assistance | $241 - $414 | 26% |
| Axa Assistance Us | $241 - $414 | 26% |
| Axis Services | $241 - $414 | 26% |
| Desjardins Financial Security Life Assurance | $241 - $414 | 26% |
| Global Benefits Group | $241 - $414 | 26% |
| Global Health Claim Services | $241 - $414 | 26% |
| Morgan White Administrators | $241 - $414 | 26% |
| National Healthcare Solutions | $241 - $414 | 26% |
| Olympus Managed Health Care | $241 - $414 | 26% |
| Penfield Care | $241 - $414 | 26% |
| Sanus Healthcare | $241 - $414 | 26% |
| Selectcare Worldwide | $241 - $414 | 26% |
| Star Healthcare Network | $241 - $414 | 26% |
| Sunmed International | $241 - $414 | 26% |
| Ww Concierge Healthcare Service | $241 - $414 | 26% |
| Auto Liabililty Praxis | $292 - $501 | 32% |
| Wc Praxis Health Network | $292 - $501 | 32% |
| Trustbridge | $928 | 100% |
| Catholic Hospice | $947 | 102% |
| Vitas Healthcare Corp | $947 | 102% |