CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Mercyone Elkader Medical Center
Billing Code: 43239 (CPT)
The BaseRate · fair price low confidence
A fair price for this
$278
about 0.3× the $927 Medicare rate · typically $126–$1,242
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $278 Hospital's list price $1,386
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 | $764 - $1,213 | 82% |
| Blue Cross Blue Shieldmajor | $713 | 77% |
| Aetnamajor | $115 - $1,020 | 12% |
| Cignamajor | $1,358 | 147% |
| Ambetter (Centene) | $1,211 | 131% |
| GEHA | $1,213 | 131% |
| HealthPartners | $1,333 | 144% |
| Medica | $1,358 | 147% |
| Medical Mutual | $1,020 | 110% |
| + 18 smaller / regional plans | $157 - $1,449 |
Government programs also on file: Medicare, Medicaid.
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
Insurance Before you use insurance
Other Procedures at Mercyone Elkader Medical Center
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.