CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$410
about 0.4× the $927 Medicare rate · typically $161–$1,324
modeled estimate · not a bill or quote
What this hospital charges insurers
$288
Below the fair price — a good deal
about $122 under the fair price · 0.3× Medicare
Medicare pays $927 Fair price $410 This hospital $288 Cash price $771 Hospital's list price $1,285

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 $288

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 $410 (about 0.4× the $927 Medicare rate). Iowa Specialty Hospital - Clarion charges insurers about $288, or about $771 in cash — below the fair price — a good deal. Located in Clarion, 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✓ Cigna HumanaKaiser 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 $345 37%
Blue Cross Blue Shieldmajor $249 27%
Aetnamajor $134 14%
Cignamajor $288 31%
HealthPartners $313 - $964 34%
+ 2 smaller / regional plans $190 - $835
Government programs also on file: Military & VA.
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1316 South Main Street, Clarion, IA 50525
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals