CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Deaconess Henderson Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $539
  • Cash Discount Price: $455
  • vs. Medicare Baseline: 0.58x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Deaconess Henderson Hospital is $539. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $455. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.58x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.
Cash / Self-Pay
$455

Average discount available for prompt cash payment at this facility.

Insurance Median
$539

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: $455 (49%)
Insurance Median: $539 (58%)
Cash: $455 (49% of Medicare)
Ins. Median: $539 (58% 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
Aetna $123 - $796 13%
Blue Cross Blue Shield $123 - $796 13%
Humana $123 - $796 13%
Medicare (plans) $123 - $796 13%
Mhs Mco $123 - $796 13%
Molina Healthcare Of Ky $123 - $796 13%
Molina Healthcare Of Ky - Exchange $123 - $796 13%
Mytru Advantage $123 - $796 13%
Umwa $123 - $796 13%
UnitedHealthcare $123 - $5,654 13%
Wellcare Il $123 - $796 13%
Wellcare Ky $123 - $955 13%
Caresource In Marketplace $160 - $1,194 17%
Wellcare Ky Commercial Exchange $160 - $1,632 17%
Alliance Coal $170 - $1,194 18%
Medicaid / KanCare $179 - $342 19%
Center Care Narrow $197 21%
Center Care Open Access $197 21%
Noncontracted $197 - $1,274 21%
Caresource In $342 37%
Ky Racing Health & Welfare Fund $455 49%
Self-Pay $455 49%
Encircle/Encore Combined $539 58%
Encircle/Encore Prime $539 58%
First Health Network (Coventry) $609 66%
Healthlink $609 66%
Iu Health Plans $609 66%
Phcs/Multiplan $609 66%
Sagamore $609 66%
Cigna $780 84%
Claimdoc $780 - $1,911 84%
Hopetrust $780 - $1,911 84%
Hstechnology $780 - $1,911 84%
Amish And Mennonite Of Western Ky $845 - $1,194 91%
Coventry National Network $1,040 112%
Webster County Detention Center $1,040 112%
Henderson County Detention Center $1,170 126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 N Elm St, Henderson, KY 42420
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals