Upper endoscopy with biopsy
Facility: Kosciusko Community Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $387
- Cash Discount Price: $149
- vs. Medicare Baseline: 0.42x 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 | $69 - $2,717 | 7% |
| Self Pay | $69 - $2,717 | 7% |
| Lutheran Preferred Network | $104 - $10,350 | 11% |
| One Call Care Diagnostics Wc | $116 | 13% |
| Physicians Health Plan | $121 - $5,962 | 13% |
| Php Freedom Network | $127 - $4,996 | 14% |
| UnitedHealthcare | $128 - $6,805 | 14% |
| Encore | $132 - $5,175 | 14% |
| Trma Inc | $132 - $1,121 | 14% |
| Aetna | $135 - $6,883 | 15% |
| Connecticut General Life Insurance Company | $194 - $7,620 | 21% |
| Cigna | $208 - $8,176 | 22% |
| First Health Network | $247 - $9,703 | 27% |
| Prime Health Services | $247 - $9,703 | 27% |
| Advantage Health | $273 - $10,738 | 29% |
| Private Healthcare Systems | $283 - $11,126 | 31% |
| Sagamore | $290 - $12,161 | 31% |
| Encore Health Network | $306 - $12,032 | 33% |
| Veterans Eval Services | $329 - $331 | 36% |
| Tricare | $912 | 98% |
| Department Of Veterans Affairs | $960 | 104% |
| Blue Cross Blue Shield | $1,011 - $3,944 | 109% |
| Humana | $1,011 - $2,274 | 109% |
| Medicare (plans) | $1,011 | 109% |
| Mhs | $1,011 - $2,274 | 109% |
| Iu Health | $1,028 | 111% |
| Node Non Par Hospice Agree | $1,028 | 111% |
| Node Va | $1,028 | 111% |
| Node Devoted Health Mcr Adv | $1,032 | 111% |
| In Dept Of Correction | $1,069 | 115% |
| Node Pphp Mcr Adv | $1,079 | 116% |
| Us Department Of Labor | $1,285 | 139% |
| Lutheran Advanced Network | $1,542 | 166% |
| Lutheran Preferred | $1,542 - $2,055 | 166% |
| Align In Work Comp | $1,644 | 177% |
| One Call Work Comp | $1,644 | 177% |
| Caresource | $1,749 - $2,274 | 189% |
| Encore Work Comp In | $1,850 | 200% |
| Managed Health Services Exchange | $2,055 | 222% |
| Workers Comp | $2,055 | 222% |
| Managed Health Services | $2,274 | 245% |
| Medicaid / KanCare | $2,274 | 245% |
| Encore Kba Epo | $2,467 | 266% |
| Encore Kba Ppo | $3,083 | 333% |