CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Tampa General Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,421
  • Cash Discount Price: $706
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Tampa General Hospital is $1,421. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $706. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.53x the Medicare baseline. Located in 1 Tampa General Cir, Tampa, FL.
Cash / Self-Pay
$706

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,421

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: $706 (76%)
Insurance Median: $1,421 (153%)
Cash: $706 (76% of Medicare)
Ins. Median: $1,421 (153% 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
Capital Health Plan Tallahassee $947 102%
Aetna $957 103%
Care Plus Health Plans $962 104%
Blue Cross Blue Shield $963 104%
Freedom Health $966 104%
Baycare $976 105%
Ultimate Health Plans $994 107%
Simply Healthcare $1,004 - $1,591 108%
Cigna $1,013 - $2,121 109%
Longevity $1,032 111%
Kaiser $1,042 112%
Devoted Health $1,061 115%
Avmed $1,327 - $1,612 143%
Molina $1,421 153%
Sunshine Health $1,434 - $1,515 155%
Health First Health Plans $1,705 184%
Truli For Health $1,800 194%
Oscar $1,894 204%
Phcs $1,900 - $2,000 205%
UnitedHealthcare $2,116 - $2,923 228%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Tampa General Cir, Tampa, FL 33606
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals