CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$932

about 1.0× the $927 Medicare rate · typically $549–$962

modeled estimate · not a bill or quote

What this hospital charges insurers

$882

About the fair price

about $50 under the fair price · 1.0× Medicare

Medicare pays $927 Fair price $932 This hospital $882 Cash price $2,332 Hospital's list price $3,331

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

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

Cheapest $115 Priciest $882

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

A fair price for a Upper endoscopy with biopsy is about $932 (about 1.0× the $927 Medicare rate). University of Iowa Health Care Medical Center Down charges insurers about $882, or about $2,332 in cash — about the fair price. Located in Iowa City, IA.

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✓ Aetna✓ Humana CignaKaiser 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	$124 - $6,174	13%
Blue Cross Blue Shieldmajor	$116 - $1,943	13%
Aetnamajor	$115 - $3,089	12%
Humanamajor	$909	98%
HealthPartners	$117 - $3,440	13%
Molina	$115 - $1,619	12%
Oscar Health	$1,647 - $2,550	178%
Sanford Health Plan	$2,223 - $3,440	240%
+ 10 smaller / regional plans	$115 - $3,642

Excludes 5 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 2,332), 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 University of Iowa Health Care Medical Center Down 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 University of Iowa Health Care Medical Center Down

Compare: Upper endoscopy with biopsy at other IA hospitals

Waverly Health Center · Waverly $115
Mahaska Health Partnership · Oskaloosa $115
Guthrie County Hospital · Guthrie Center $117
Story County Hospital · Nevada $124
Cass County Memorial Hospital · Atlantic $127
Clarke County Hospital · Osceola $142
Virginia Gay Hospital · Vinton $159
Winnmed · Decorah $164

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