Upper endoscopy with biopsy
Facility: Lutheran Hospital of Indiana
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $361
- Cash Discount Price: $197
- vs. Medicare Baseline: 0.39x 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 |
|---|---|---|
| Ky Work Comp | $83 - $2,868 | 9% |
| Amish Aid | $99 - $3,414 | 11% |
| Lutheran Preferred Network | $99 - $6,828 | 11% |
| Self Pay | $99 - $3,414 | 11% |
| Cigna | $106 - $4,131 | 11% |
| One Call Care Diagnostics | $116 | 13% |
| Physicians Health Plan Of Northern Indiana | $130 - $4,493 | 14% |
| Aetna | $132 - $5,417 | 14% |
| Lutheran Preferred | $132 - $1,144 | 14% |
| Sagamore | $150 - $6,157 | 16% |
| Encore Ppo | $161 - $5,565 | 17% |
| Lutheran Network | $164 - $5,690 | 18% |
| Multiplan | $240 - $9,445 | 26% |
| Prime Health Services | $247 - $8,535 | 27% |
| Encore Health Network | $270 - $10,242 | 29% |
| Advantage Health Solutions | $273 - $9,445 | 29% |
| Allied Benefit Systems | $296 - $10,242 | 32% |
| Evolutions | $296 - $10,242 | 32% |
| Blue Cross Blue Shield | $329 - $3,944 | 36% |
| Veterans Eval Services | $329 - $331 | 36% |
| UnitedHealthcare | $850 - $6,759 | 92% |
| Tricare | $912 | 98% |
| Humana | $944 - $2,274 | 102% |
| Iu Health Plan | $944 | 102% |
| Managed Health Services | $944 - $2,274 | 102% |
| Medicare (plans) | $944 | 102% |
| Department Of Veterans Affairs | $960 | 104% |
| Node Hospice Non Par Agree | $960 | 104% |
| Node Va | $960 | 104% |
| Node Devoted Health Mcr Adv | $963 | 104% |
| In Dept Of Correction | $998 | 108% |
| Node Pphp Mcr Adv | $1,008 | 109% |
| Us Department Of Labor | $1,200 | 130% |
| Lutheran Advanced Network | $1,439 | 155% |
| Node Lutheran Network | $1,439 - $1,679 | 155% |
| Node Lutheran Preferred Fixed 2 | $1,439 | 155% |
| Align Network | $1,535 | 166% |
| Encore Work Comp In | $1,727 | 186% |
| Care Source | $2,274 | 245% |
| Medicaid / KanCare | $2,274 | 245% |
| Node Encore Kba Epo | $2,303 | 249% |
| Php Freedom Network | $2,851 | 308% |
| Node Encore Kba Ppo | $2,879 | 311% |