CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: University of Illinois Hospital and Clinics

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$439

about 0.5× the $927 Medicare rate · typically $205–$845

modeled estimate · not a bill or quote

What this hospital charges insurers

$190

Below the fair price — a good deal

about $249 under the fair price · 0.2× Medicare

Medicare pays $927 Fair price $439 This hospital $190 Cash price $1,404 Hospital's list price $2,237

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $82 Priciest $190

Black dot = this hospital, among the 9 IL 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 $439 (about 0.5× the $927 Medicare rate). University of Illinois Hospital and Clinics charges insurers about $190, or about $1,404 in cash — below the fair price — a good deal. Located in Chicago, IL.

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	$144 - $251	16%
Blue Cross Blue Shieldmajor	$132 - $618	14%
Aetnamajor	$138 - $618	15%
Cignamajor	$231 - $5,766	25%
Health Net	$225	24%
HealthLink	$226 - $5,138	24%
HealthPartners	$188	20%
Meridian	$618	67%
Molina	$115 - $618	12%
WellCare	$151	16%
+ 31 smaller / regional plans	$144 - $4,671

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

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 1,404), 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 University of Illinois Hospital and Clinics 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 University of Illinois Hospital and Clinics

Compare: Upper endoscopy with biopsy at other IL hospitals

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