CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Clearwater Valley Hospital & Clinics

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$252
about 0.3× the $927 Medicare rate · typically $145–$1,233
modeled estimate · not a bill or quote
What this hospital charges insurers
$213
Below the fair price — a good deal
about $39 under the fair price · 0.2× Medicare
Medicare pays $927 Fair price $252 This hospital $213 Cash price $250 Hospital's list price $333

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

A typical price — 3 charge more and 4 charge less, among the 9 ID hospitals compared.

Cheapest $99 Priciest $284

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

A fair price for a Upper endoscopy with biopsy is about $252 (about 0.3× the $927 Medicare rate). Clearwater Valley Hospital & Clinics charges insurers about $213, or about $250 in cash — below the fair price — a good deal. Located in Orofino, ID.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $298 32%
Blue Cross Blue Shieldmajor $116 - $283 13%
Aetnamajor $185 20%
Cignamajor $258 28%
Humanamajor $116 - $196 13%
GEHA $323 35%
+ 5 smaller / regional plans $116 - $367
Government programs also on file: Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 301 Cedar Street, Orofino, ID 83544
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals