CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: St Charles Parish Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $861
  • Cash Discount Price: $613
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at St Charles Parish Hospital is $861. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $613. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.93x the Medicare baseline. Located in 1057 Paul Maillard Road, Luling, LA.
Cash / Self-Pay
$613

Average discount available for prompt cash payment at this facility.

Insurance Median
$861

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: $613 (66%)
Insurance Median: $861 (93%)
Cash: $613 (66% of Medicare)
Ins. Median: $861 (93% 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
Tricare $338 - $818 36%
Amerihealth Caritas Louisiana (Healthy Louisiana) $468 51%
Healthy Blue (Healthy Louisiana) $468 51%
Humana $468 - $861 51%
Louisiana Healthcare Connections (Healthy Louisiana) $468 51%
UnitedHealthcare $468 - $1,974 51%
Aetna $482 - $1,093 52%
Medicaid / KanCare $672 73%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan) $861 93%
Blue Cross Blue Shield $861 - $1,627 93%
Healthy Blue Dual Advantage (Hmo-D-Snp) $861 93%
Medicare (plans) $861 93%
Ochsner Health Plan $861 93%
Cigna $872 94%
Zelis $1,363 147%
Galaxy Health Network Ppo $1,703 184%
Galaxy Health Network Wc $1,703 184%
Louisiana Workers' Compensation Corporation (Lwcc) $1,703 184%
Healthcomp & Personify Health (Formerly Gilsbar) $1,749 189%
Claritev D/B/A Multiplan/Phcs/American Life Care $1,817 196%
First Health Network $1,930 208%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1057 Paul Maillard Road, Luling, LA 70070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals