CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: University of Illinois Hospital and Clinics

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $190
  • Cash Discount Price: $1,404
  • vs. Medicare Baseline: 0.21x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at University of Illinois Hospital and Clinics is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,404. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.21x the Medicare baseline. Located in 1740 West Taylor St Suite 1400, Chicago, IL.
Cash / Self-Pay
$1,404

Average discount available for prompt cash payment at this facility.

Insurance Median
$190

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $1,404 (152%)
Insurance Median: $190 (21%)
Cash: $1,404 (152% of Medicare)
Ins. Median: $190 (21% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Molina $115 - $618 12%
Blue Cross Blue Shield $132 - $618 14%
Coventry $138 - $144 15%
Aetna $144 - $618 16%
Health Alliance $144 - $194 16%
Longevity Health Plan $144 16%
Sinai Medical Group $144 16%
United $144 - $251 16%
UnitedHealthcare $144 16%
Zing Health $147 16%
Clear Springs Health $148 16%
Village Md $151 - $180 16%
Wellcare $151 16%
Uic Physician Group $158 17%
Union Health Service $173 - $4,671 19%
Dolton Medical Associates $180 19%
Mac Neal Health Providers $180 19%
Mercy Physician Association $180 19%
Unified Physicians Network $180 19%
West Suburban Health Providers $180 19%
Lake County Physician Associates $187 20%
Northshore Physician Association $187 20%
Northwest Primary Care Alliance $187 20%
Southwest Physician Group Ltd $187 20%
Caterpillar $188 20%
Humboldt Park Health Partners $188 20%
Physicians Health Association Of Il $188 20%
Resurrection Phys Provider Group $188 20%
Valenz $191 21%
Fox Valey Medicine Ltd $194 21%
Oak West Primary Care Alliance $194 21%
Campus Care $216 23%
Healthsmart $216 23%
The Alliance $216 23%
St Anthony Health Network $225 24%
Healthlink $226 - $5,138 24%
Franciscan Hammond Clinic Llc $230 25%
Cigna $231 - $5,766 25%
Physician Care Network Inc $234 25%
Multiplan $302 - $12,040 33%
County Care Health Plan $618 67%
Meridian $618 67%
Youthcare Healthchoice $618 67%
Equian $807 87%
Zelis $807 87%
Integrated Health Plan $888 96%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1740 West Taylor St Suite 1400, Chicago, IL 60612
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals