CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Leonard J Chabert Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $861
Cash Discount Price: $764
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Leonard J Chabert Medical Center is $861. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $764. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.93x the Medicare baseline. Located in 1978 Industrial Blvd, Houma, LA.

Cash / Self-Pay

$764

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: $764 (82%)

Insurance Median: $861 (93%)

Cash: $764 (82% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $356	36%
Healthy Blue (Healthy Louisiana)	$481	52%
Humana	$481	52%
Louisiana Healthcare Connections (Healthy Louisiana)	$481	52%
UnitedHealthcare	$481 - $2,145	52%
Aetna	$496 - $1,768	54%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$496	54%
Medicaid / KanCare	$672	73%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$861	93%
Blue Cross Blue Shield	$861 - $2,234	93%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$861	93%
Medicare (plans)	$861	93%
Ochsner Health Plan	$861	93%
Verity Commercial And First Choice Network	$927	100%
Claritev D/B/A Multiplan/Phcs/American Life Care	$1,220	132%
Louisiana Workers' Compensation Corporation (Lwcc)	$1,220	132%
Cigna	$1,221	132%
First Health Network	$1,301	140%
Healthcomp & Personify Health (Formerly Gilsbar)	$1,333	144%
Usa Managed Care Network	$1,382	149%
Zelis	$2,325	251%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $764.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Leonard J Chabert Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.