CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Cameron Memorial Community Hospital Inc

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $179
Cash Discount Price: $413
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Cameron Memorial Community Hospital Inc is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $413. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.19x the Medicare baseline. Located in 416 E Maumee St, Angola, IN.

Cash / Self-Pay

$413

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $413 (45%)

Insurance Median: $179 (19%)

Cash: $413 (45% of Medicare)

Ins. Median: $179 (19% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$124	13%
Cigna	$124	13%
Corvel	$124	13%
Encore	$124	13%
Humana	$124 - $183	13%
Phcs	$124	13%
Plain Church Group Ministry	$124	13%
Sagamore Health Network	$124	13%
Caresource Indiana Of In	$137 - $342	15%
Buckeye Health	$140	15%
Molina Healthcare Of Oh	$140	15%
Coventry	$149	16%
Lucent	$174	19%
Frontpath	$177	19%
Three Rivers Preferred	$180 - $18,000	19%
Lutheran Preferred	$192	21%
Centivo	$193	21%
UnitedHealthcare	$197 - $344	21%
Php	$219	24%
Blue Cross Blue Shield	$338	36%
Managed Health Services	$342	37%
Mdwise	$342	37%
Signature Care	$462	50%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $413.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cameron Memorial Community Hospital Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.