CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Kiowa District Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$923

about 1.0× the $927 Medicare rate · typically $178–$1,593

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $923 Cash price $912 Hospital's list price $1,140

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$912 - $1,140	98%
Blue Cross Blue Shieldmajor	$1,142	123%
Aetnamajor	$1,083	117%
Humanamajor	$1,029	111%
HealthPartners	$1,003	108%
+ 4 smaller / regional plans	$1,072 - $1,841

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 912), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Kiowa District Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kiowa District Hospital

Compare: Upper endoscopy with biopsy at other KS hospitals

Insurance negotiated median for the same procedure, sorted lowest first.