Upper endoscopy with biopsy
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,404
- Cash Discount Price: $791
- vs. Medicare Baseline: 1.52x 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 |
|---|---|---|
| Medicaid / KanCare | $296 | 32% |
| Workers Comp [503999901] | $847 - $1,487 | 91% |
| UnitedHealthcare | $847 | 91% |
| Ku Athletics [503200094] | $847 | 91% |
| Medicare (plans) | $864 | 93% |
| Allwell [503200078] | $872 | 94% |
| Blue Cross Blue Shield | $872 - $1,321 | 94% |
| Triwest [503201703] | $893 | 96% |
| Tricare | $893 | 96% |
| Humana | $893 | 96% |
| Centurion [5032000966] | $1,101 | 119% |
| Ambetter / Centene | $1,228 | 133% |
| Alt Bnsf Railway Co [503301503] | $1,487 | 160% |
| Sedgwick Claims Management Services [53201618] | $1,487 | 160% |
| Prime Health Services [503999912] | $1,487 | 160% |
| Gallagher Bassett [5032000103] | $1,487 | 160% |
| Occunet [503999930] | $1,778 | 192% |
| Fort Hays State Student Athletes [5032000960] | $1,778 | 192% |
| 6 Degrees Health [503999050] | $2,117 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $2,680 | 289% |
Consumer Guidance & Cost Commentary
For an upper endoscopy with biopsy at the University of KS Health System Great Bend Campus, the cash price is $791, which is significantly lower than the facility's negotiated rates ranging from $847 to $2,680 depending on the payer. While the facility's cash rate is well below the gross charge of $3,954, patients should be aware that insurance negotiated rates often exceed the cash price due to administrative costs and contract structures. If you have a high-deductible plan, paying the cash price upfront may result in lower out-of-pocket costs compared to your insurance allowed amount, provided you secure a prompt-pay discount before scheduling.
The facility's cash rate of $791 is notably lower than the state average for this procedure, offering a clear financial advantage for self-pay patients. However, because this is an in-network facility, balance billing is generally prohibited under the No Surprises Act for emergency care and non-emergency services from out-of-network providers at the hospital. To ensure you receive the best possible rate, it is recommended to explicitly request a self-pay classification and prompt-pay discount at registration, rather than waiting until after receiving a bill. Always verify your specific plan's deductible status and ask the billing department for an itemized statement to confirm that no unexpected charges are included.