Upper endoscopy with biopsy
Facility: Northwest Health-La Porte
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $735
- Cash Discount Price: $293
- vs. Medicare Baseline: 0.79x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Lutheran | $102 - $1,199 | 11% |
| One Call | $116 | 13% |
| Self Pay | $124 - $5,975 | 13% |
| Php | $155 - $7,480 | 17% |
| Lutheran Preferred Medpartners | $157 - $7,569 | 17% |
| Alpha Baking | $169 - $8,148 | 18% |
| Php Freedom Network | $226 - $10,897 | 24% |
| Encore | $244 - $16,296 | 26% |
| County Of Laporte | $263 - $12,675 | 28% |
| UnitedHealthcare | $275 - $12,747 | 30% |
| Cigna | $279 - $13,453 | 30% |
| Prime Health Services | $282 - $13,580 | 30% |
| Prime Health Services Auto | $282 - $13,580 | 30% |
| Aetna | $292 - $14,974 | 32% |
| Ihn | $301 - $14,485 | 32% |
| Community Health Alliance | $327 - $15,753 | 35% |
| Lutheran Network | $331 - $15,934 | 36% |
| Sagamore Health Network | $331 - $15,934 | 36% |
| Chandler Group | $338 - $16,296 | 36% |
| Hfn Workers Compensation | $338 - $16,296 | 36% |
| Multiplan | $338 - $16,296 | 36% |
| Phcs | $338 - $16,296 | 36% |
| Tricare | $912 | 98% |
| Blue Cross Blue Shield | $946 - $3,911 | 102% |
| Humana | $946 - $2,274 | 102% |
| Medicare (plans) | $946 | 102% |
| Node Champva | $960 | 104% |
| Node Hospice Non Par Agree | $962 | 104% |
| Node Va | $962 | 104% |
| Va Choice Program | $962 | 104% |
| Node Devoted Health Mcr Adv | $965 | 104% |
| Managed Health Services | $994 - $2,274 | 107% |
| Indiana Dept Of Correction | $1,000 | 108% |
| Node Pphp Mcr Adv | $1,010 | 109% |
| Us Department Of Labor | $1,202 | 130% |
| Prime Health In Work Comp | $1,731 | 187% |
| Caresource | $1,749 - $2,274 | 189% |
| In Wc | $1,923 | 208% |
| Medicaid / KanCare | $2,274 | 245% |
| Mhs | $2,274 | 245% |
| Encore Kba Epo | $2,308 | 249% |
| Magnacare Ma | $2,354 | 254% |
| Encore Kba Ppo | $2,885 | 311% |