CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $858
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Baptist Health Medical Center - Jacksonville is $858. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.93x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$858

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%)
Insurance Median: $858 (93%)
Ins. Median: $858 (93% 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

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
Amerigroup Of Georgia $649 70%
Caresource Of Georgia $649 70%
Daniel Memorial $649 70%
Humana $649 - $714 70%
Peach State Health Plan $649 70%
Simply Healthcare Plans $681 - $779 73%
Simply Healthcare Plans - Cha $681 73%
Amerihealth Caritas $714 77%
Florida Community Care $714 - $988 77%
Sunshine State Health Plan $714 77%
United Community Plan $714 77%
Vivida Health $714 77%
Molina Healthcare Of Florida $772 83%
Aetna $779 - $960 84%
Community Hospice Of Northeast Florida $938 - $941 101%
Pace $938 - $941 101%
Tomorrow'S Rainbow $938 - $941 101%
Va Ccn $938 - $941 101%
UnitedHealthcare $947 - $951 102%
Devoted $994 - $998 107%
Upmc $1,031 - $1,035 111%
Ambetter / Centene $2,250 - $2,259 243%
Corvel $2,715 293%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals