CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Memorial Hospital Miramar

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,223

about 1.3× the $927 Medicare rate · typically $816–$1,675

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,170

About the fair price

about $53 under the fair price · 1.3× Medicare

Medicare pays $927 Fair price $1,223 This hospital $1,170 Cash price $3,410 Hospital's list price $4,871

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 $1,170

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 $1,223 (about 1.3× the $927 Medicare rate). Memorial Hospital Miramar charges insurers about $1,170, or about $3,410 in cash — about the fair price. Located in Miramar, FL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna✓ Cigna✓ Humana Blue Cross Blue ShieldKaiser 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	$1,137	123%
Aetnamajor	$779 - $1,051	84%
Cignamajor	$838 - $2,236	90%
Humanamajor	$1,023	110%
AvMed	$588 - $2,305	63%
Health Net	$1,559	168%
WellCare	$1,004 - $1,032	108%
+ 28 smaller / regional plans	$718 - $4,140

Excludes 3 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 3,410), 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 Memorial Hospital Miramar 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 (%)

Enter your details and press estimate to compare.

Other Procedures at Memorial Hospital Miramar

Compare: Upper endoscopy with biopsy at other FL hospitals

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