CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Northwest Florida Community Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$463

about 0.5× the $927 Medicare rate · typically $142–$3,012

modeled estimate · not a bill or quote

What this hospital charges insurers

$159

Below the fair price — a good deal

about $304 under the fair price · 0.2× Medicare

Medicare pays $927 Fair price $463 This hospital $159 Cash price $289 Hospital's list price $362

How we calculate the fair BaseRate →

How this hospital compares to other FL hospitals

One of the lower prices — 7 of 8 other FL hospitals charge more for the same procedure.

Cheapest $93 Priciest $601

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 $463 (about 0.5× the $927 Medicare rate). Northwest Florida Community Hospital charges insurers about $159, or about $289 in cash — below the fair price — a good deal. Located in Chipley, 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✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser 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	$134 - $312	14%
Blue Cross Blue Shieldmajor	$276 - $1,320	30%
Cignamajor	$288 - $456	31%
Humanamajor	$76 - $159	8%
WellCare	$93	10%
+ 3 smaller / regional plans	$93

Government programs also on file: Medicare.

Excludes 1 rental-network / third-party entry (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 289), 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 Northwest Florida Community Hospital 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 Northwest Florida Community Hospital

Compare: Upper endoscopy with biopsy at other FL hospitals

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