Upper endoscopy with biopsy
Facility: Bluffton Regional Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $436
- Cash Discount Price: $243
- vs. Medicare Baseline: 0.47x 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 |
|---|---|---|
| Amish Aid | $79 - $3,888 | 9% |
| Self Pay | $79 - $3,888 | 9% |
| Lutheran Preferred Network | $98 - $12,959 | 11% |
| Cigna | $104 - $5,735 | 11% |
| Aetna | $119 - $7,225 | 13% |
| Php Management Systems | $127 - $6,272 | 14% |
| Lutheran Trma | $132 - $1,121 | 14% |
| UnitedHealthcare | $154 - $8,002 | 17% |
| Encore Ppo | $161 - $7,921 | 17% |
| Sagamore Sebt | $168 - $8,278 | 18% |
| Sagamore Health Newtork Inc | $176 - $8,683 | 19% |
| Consumer Life | $204 - $10,044 | 22% |
| Ahg Dana Employees | $214 - $2,399 | 23% |
| Align Networks | $230 - $11,340 | 25% |
| Prime Health Services | $247 - $12,150 | 27% |
| Private Healthcare Systems Inc | $247 - $12,150 | 27% |
| Multiplan | $263 - $12,959 | 28% |
| Encore Health Network | $270 - $14,579 | 29% |
| Advantage 360 | $273 - $13,445 | 29% |
| Community Health Alliance | $280 - $13,769 | 30% |
| First Health | $283 - $13,931 | 31% |
| Allied Benefit Systems | $296 - $14,579 | 32% |
| Cardinal Health Alliance | $296 - $14,579 | 32% |
| Ppom | $296 - $14,579 | 32% |
| Veterans Eval Services | $329 - $331 | 36% |
| Tricare | $912 | 98% |
| Blue Cross Blue Shield | $944 - $3,944 | 102% |
| Medicare (plans) | $944 | 102% |
| Node Iu Health Mcr Adv | $944 | 102% |
| Node Mhs Mcr Adv | $944 | 102% |
| Department Of Veterans Affairs | $960 | 104% |
| Humana | $960 - $2,274 | 104% |
| Node Non Par Hospice Agree | $960 | 104% |
| Node Va | $960 | 104% |
| Northeast Hospice | $960 | 104% |
| Node Caresource Mcr Adv | $963 | 104% |
| Node Devoted Health Mcr Adv | $963 | 104% |
| County Jail Health Care | $998 | 108% |
| 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% |
| Lutheran Three Rivers Preferred Plus 150 | $1,439 | 155% |
| Lutheran Three Rivers Preferred Plus 175 | $1,679 | 181% |
| Physicians Health Plan | $1,689 | 182% |
| Encore Work Comp In | $1,727 | 186% |
| Php | $1,792 | 193% |
| Lutheran Northwest Health Preferred | $1,919 | 207% |
| Managed Health Services Exchange | $1,919 | 207% |
| Workers Compensation | $1,919 | 207% |
| Caresource | $2,274 | 245% |
| Medicaid / KanCare | $2,274 | 245% |
| Mhs | $2,274 | 245% |
| Mhs In Hip | $2,274 | 245% |
| Encore Kba Epo | $2,303 | 249% |
| Php Freedom Network | $2,690 | 290% |
| Encore Kba Ppo | $2,879 | 311% |