Upper endoscopy with biopsy
Facility: Lower Keys Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,133
- Cash Discount Price: $3,947
- vs. Medicare Baseline: 1.22x 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 |
|---|---|---|
| UnitedHealthcare | $62 - $11,242 | 7% |
| Veterans Eval Services | $345 | 37% |
| Tricare | $964 | 104% |
| Florida Childrens Medical Services | $990 | 107% |
| Medicaid / KanCare | $990 - $1,089 | 107% |
| South Florida Community Care Network | $990 | 107% |
| Blue Cross Blue Shield | $998 - $13,432 | 108% |
| Humana | $998 - $1,020 | 108% |
| Medicare (plans) | $998 | 108% |
| Ultimate Health | $998 | 108% |
| Node Champva | $1,014 | 109% |
| Node Non Par Hospice Agree | $1,014 | 109% |
| Node United Behavioral Va Ccn | $1,014 | 109% |
| Node Va | $1,014 | 109% |
| Amerigroup | $1,089 | 118% |
| Positive Healthcare | $1,089 | 118% |
| Simply Healthcare | $1,089 - $3,000 | 118% |
| Wellcare | $1,089 | 118% |
| Wellcare Healthease | $1,089 | 118% |
| Correct Care Solutions | $1,116 | 120% |
| Molina | $1,119 | 121% |
| Prestige Health Choice | $1,148 | 124% |
| Magellan | $1,188 | 128% |
| Node Us Dept Of Labor | $1,268 | 137% |
| Prime Health Work Comp Fl | $1,351 | 146% |
| Fl Work Comp | $1,392 | 150% |
| Heritage Summit Work Comp Fl | $1,392 | 150% |
| State Auto Insurance Fl | $2,029 | 219% |
| Self Pay | $3,947 | 426% |
| Cigna | $8,625 | 931% |
| Aetna | $10,204 | 1101% |
| Monroe County | $10,964 | 1183% |
| Evolutions Healthcare Systems | $11,695 - $13,888 | 1262% |
| Keys Energy | $11,695 | 1262% |
| Prime Health Ppo | $11,695 | 1262% |
| Avmed Health Plan | $12,426 | 1341% |
| Direct Healthcare | $14,619 | 1578% |