CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Tanner Medical Center Villa Rica

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,578

about 1.7× the $927 Medicare rate · typically $924–$3,912

modeled estimate · not a bill or quote

What this hospital charges insurers

$941

Below the fair price — a good deal

about $637 under the fair price · 1.0× Medicare

Medicare pays $927 Fair price $1,578 This hospital $941 Cash price $1,251 Hospital's list price $3,128

How we calculate the fair BaseRate →

How this hospital compares to other GA hospitals

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

Cheapest $158 Priciest $941

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

A fair price for a Upper endoscopy with biopsy is about $1,578 (about 1.7× the $927 Medicare rate). Tanner Medical Center Villa Rica charges insurers about $941, or about $1,251 in cash — below the fair price — a good deal. Located in Villa Rica, GA.

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✓ Kaiser Permanente Blue Cross Blue ShieldHumana

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	$905	98%
Aetnamajor	$923	100%
Cignamajor	$932	101%
Kaiser Permanentemajor	$905 - $1,086	98%
Clover Health	$951	103%
+ 1 smaller / regional plan	$996

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 1,251), 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 Tanner Medical Center Villa Rica 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 Tanner Medical Center Villa Rica

Compare: Upper endoscopy with biopsy at other GA hospitals

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