CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Lakeside Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,032

about 1.1× the $927 Medicare rate · typically $708–$1,685

modeled estimate · not a bill or quote

What this hospital charges insurers

$941

About the fair price

about $91 under the fair price · 1.0× Medicare

Medicare pays $927 Fair price $1,032 This hospital $941 Cash price $941 Hospital's list price $2,235

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

Highest price of the 9 FL hospitals we have prices for — worth calling around.

Cheapest $93 Priciest $941

Black dot = this hospital, among the 9 FL hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,032 (about 1.1× the $927 Medicare rate). Lakeside Medical Center charges insurers about $941, or about $941 in cash — about the fair price. Located in Belle Glade, FL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$67 - $941	7%
Blue Cross Blue Shieldmajor	$941 - $2,459	102%
Aetnamajor	$133 - $1,564	14%
Cignamajor	$674 - $2,909	73%
Humanamajor	$941	102%
Ambetter (Centene)	$988	107%
Devoted Health	$1,007	109%
Molina	$941 - $988	102%
Simply Healthcare	$941	102%
WellCare	$988	107%
+ 5 smaller / regional plans	$894 - $2,909

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 941), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Lakeside Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Lakeside Medical Center

Compare: Upper endoscopy with biopsy at other FL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.