CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Nell J Redfield Memorial Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$375

about 0.4× the $927 Medicare rate · typically $124–$1,300

modeled estimate · not a bill or quote

What this hospital charges insurers

$118

Below the fair price — a good deal

about $257 under the fair price · 0.1× Medicare

Medicare pays $927 Fair price $375 This hospital $118 Cash price $929 Hospital's list price $1,094

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

One of the lower prices — 6 of 8 other ID hospitals charge more for the same procedure.

Cheapest $99 Priciest $284

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $375 (about 0.4× the $927 Medicare rate). Nell J Redfield Memorial Hospital charges insurers about $118, or about $929 in cash — below the fair price — a good deal. Located in Malad City, ID.

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	$116 - $1,024	13%
Blue Cross Blue Shieldmajor	$116 - $1,145	13%
Aetnamajor	$116 - $988	13%
PacificSource	$119 - $621	13%
+ 5 smaller / regional plans	$51 - $1,181

Excludes 2 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 929), 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 Nell J Redfield Memorial Hospital 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 Nell J Redfield Memorial Hospital

Compare: Upper endoscopy with biopsy at other ID hospitals

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