CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Ascension St Vincent Warrick

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $274
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.30x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Ascension St Vincent Warrick is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.30x the Medicare baseline. Located in 1116 Millis Ave, Boonville, IN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$274

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%)
Insurance Median: $274 (30%)
Ins. Median: $274 (30% 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
UnitedHealthcare $56 - $460 6%
Blue Cross Blue Shield $270 - $460 29%
Encore Exclusive $270 29%
Patoka Valley Tier 1 $270 29%
Patoka Valley Tier 2 $270 29%
Medicaid / KanCare $274 30%
Mhs Care Connect $274 30%
Aetna $460 50%
Ambetter / Centene $460 50%
Ascension Complete Mcr $460 50%
Caresource Marketplace $460 50%
Corizon $460 50%
Humana $460 50%
Immergrun $460 50%
Medicare (plans) $460 50%
Personalized Care $460 50%
Secure Horizons-Pacificare $460 50%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1116 Millis Ave, Boonville, IN 47601
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals