CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Clarinda Regional Health Center
Billing Code: 43239 (CPT)
The BaseRate · fair price low confidence
A fair price for this
$233
about 0.3× the $927 Medicare rate · typically $131–$1,203
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $233 Cash price $674 Hospital's list price $1,142
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
3 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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 | $104 - $1,028 | 11% |
| Blue Cross Blue Shieldmajor | $117 | 13% |
| Aetnamajor | $115 | 12% |
| Ambetter (Centene) | $115 - $1,142 | 12% |
| Amerigroup | $1,142 | 123% |
| Molina | $115 | 12% |
| + 1 smaller / regional plan | $1,142 |
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Clarinda Regional Health 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.