Upper endoscopy with biopsy
Facility: Boston Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,054
- Cash Discount Price: $997
- vs. Medicare Baseline: 1.14x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tufts Conncare/Qhp [8020] | $431 - $1,497 | 47% |
| Hsn Bad Debt [4003] | $513 | 55% |
| Hsn Confidential [4007] | $513 | 55% |
| Hsn Dental [4006] | $513 | 55% |
| Hsn Partial [4002] | $513 | 55% |
| Hsn [4001] | $513 | 55% |
| UnitedHealthcare | $695 - $2,589 | 75% |
| Tufts [8002] | $736 - $1,505 | 79% |
| Harvard Pilgrim Health Care [8001] | $762 | 82% |
| Health Plans Inc [2027] | $762 | 82% |
| United [2025] | $762 - $2,589 | 82% |
| Zzzhealth Plans Inc [1013] | $762 | 82% |
| Zzzunited [1008] | $762 - $2,589 | 82% |
| Medicaid / KanCare | $797 | 86% |
| Blue Cross Blue Shield | $871 - $1,054 | 94% |
| Uphams Corner Esp [1213] | $886 | 96% |
| Workers Comp [5002] | $950 | 103% |
| Zzzbu Employee Work Comp [5004] | $950 | 103% |
| Zzzcity Of Boston Work Comp [5003] | $950 | 103% |
| Unicare [8004] | $1,011 | 109% |
| Wellpoint [2034] | $1,011 | 109% |
| Aetna | $1,054 - $1,083 | 114% |
| Humana | $1,054 | 114% |
| Medicare (plans) | $1,054 - $1,106 | 114% |
| Neighborhood Pace [1206] | $1,054 | 114% |
| Ubh Hphc [8016] | $1,054 | 114% |
| Veterans Admin [9003] | $1,054 | 114% |
| Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] | $1,054 | 114% |
| Champva [9004] | $1,058 | 114% |
| Tricare | $1,058 | 114% |
| Meritain Health [1023] | $1,083 | 117% |
| Wellcare [1240] | $1,096 | 118% |
| Cca [1215] | $1,106 | 119% |
| Corrections [9001] | $1,106 - $1,317 | 119% |
| Zzzcca Onecare [1216] | $1,106 | 119% |
| Eternalhealth [1227] | $1,117 | 121% |
| Fallon Sco [1126] | $1,159 | 125% |
| Mass General Brigham Health Plan Commercial [8009] | $1,195 | 129% |
| Senior Whole Health [1210] | $1,264 | 136% |
| Fallon [8008] | $1,370 | 148% |
| Cigna | $1,505 - $1,883 | 162% |
| Oxford Health [1007] | $2,589 | 279% |
| Oxford Health [2024] | $2,589 | 279% |