CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Cooley Dickinson Hospital Inc,The

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,089

about 1.2× the $927 Medicare rate · typically $906–$1,404

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,113

About the fair price

about $24 over the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,089 This hospital $1,113 Cash price $1,191 Hospital's list price $1,588

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $380 Priciest $1,113

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Upper endoscopy with biopsy is about $1,089 (about 1.2× the $927 Medicare rate). Cooley Dickinson Hospital Inc,The charges insurers about $1,113, or about $1,191 in cash — about the fair price. Located in Northampton, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$1,113 - $1,588	120%
Blue Cross Blue Shieldmajor	$871 - $1,113	94%
Aetnamajor	$1,113 - $1,477	120%
Cignamajor	$1,542	166%
Humanamajor	$1,113	120%
Harvard Pilgrim	$762	82%
Tufts Health Plan	$1,113 - $3,124	120%
+ 3 smaller / regional plans	$958 - $1,147

Government programs also on file: Medicare.

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 1,191), 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 Cooley Dickinson Hospital Inc,The 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 Cooley Dickinson Hospital Inc,The

Compare: Upper endoscopy with biopsy at other MA hospitals

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