CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Deaconess Hospital Inc

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $382
  • Cash Discount Price: $455
  • vs. Medicare Baseline: 0.41x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Deaconess Hospital Inc is $382. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $455. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.41x the Medicare baseline. Located in 600 Mary St, Evansville, IN.
Cash / Self-Pay
$455

Average discount available for prompt cash payment at this facility.

Insurance Median
$382

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: $455 (49%)
Insurance Median: $382 (41%)
Cash: $455 (49% of Medicare)
Ins. Median: $382 (41% 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
Blue Cross Blue Shield $124 - $2,859 13%
Humana $124 - $890 13%
Medicare (plans) $124 - $890 13%
Meridiancare (Il) $124 - $890 13%
Molina (Il) Mmai $124 - $890 13%
Molina Il $124 - $890 13%
Mytru Advantage $124 - $890 13%
Triwest Vapc3 $124 - $846 13%
UnitedHealthcare $124 - $5,627 13%
Wellcare (Il) Mmai $124 - $890 13%
Aetna $128 - $609 14%
Medicaid / KanCare $134 - $342 14%
Meridiancomplete (Il) $134 - $890 14%
Meridianhealth (Il) $134 14%
Youthcare (Meridian Il) $134 14%
Youthcare (Wellcare Il) $134 14%
Immergrun $153 - $1,068 17%
Ambetter / Centene $155 - $1,335 17%
Caresource In Marketplace $161 - $1,335 17%
Alliance Coal $171 - $1,736 18%
Allied National $174 - $2,136 19%
Claimdoc $174 - $2,136 19%
Healthscope $174 - $2,136 19%
Hopetrust $186 - $2,136 20%
Hstechnology $186 - $2,136 20%
Patoka Valley Health Care (80/20 Plan) $186 - $1,792 20%
Patoka Valley Health Care (90/10 Plan) $186 - $1,670 20%
Center Care Narrow Select $197 21%
Center Care Open Access $197 21%
Noncontracted $199 - $1,424 21%
Deaconess Onecare $205 - $1,780 22%
Iu Health Network $205 22%
Naphcare $205 - $1,469 22%
Chamber Care $211 - $2,136 23%
United Behavioral Health $248 27%
Mhnet $274 30%
Caresource In $342 37%
Ky Racing Health & Welfare Fund $455 49%
Self-Pay $455 49%
Encircle/Encore Combined $539 58%
Encircle/Encore Elite+ $539 - $1,958 58%
Encircle/Encore Prime $539 58%
Cigna $609 66%
Claritev (Formerly Phcs Multiplan) $609 66%
First Health $609 66%
Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) $609 - $890 66%
Parkview Signature Care $884 95%
Healthlink $975 - $1,105 105%
National Rural Electric $1,144 123%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Mary St, Evansville, IN 47747
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals