CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Tufts Medical Center
Billing Code: 43239 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$1,278
about 1.4× the $927 Medicare rate · typically $824–$1,974
modeled estimate · not a bill or quote
Medicare pays $927 Fair price $1,278 Cash price $1,052 Hospital's list price $1,502
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 | $762 - $2,391 | 82% |
| Blue Cross Blue Shieldmajor | $435 - $2,003 | 47% |
| Aetnamajor | $313 - $2,003 | 34% |
| Cignamajor | $501 - $2,010 | 54% |
| Humanamajor | $2,003 | 216% |
| AmeriHealth | $351 - $701 | 38% |
| AvMed | $351 - $701 | 38% |
| GEHA | $351 - $701 | 38% |
| Harvard Pilgrim | $762 - $2,391 | 82% |
| Tufts Health Plan | $284 - $2,010 | 31% |
| WellSense | $263 - $714 | 28% |
| + 108 smaller / regional plans | $351 - $2,391 |
Government programs also on file: Medicare, Medicaid.
Excludes 12 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Tufts Medical Center
Compare: Upper endoscopy with biopsy at other MA hospitals
- Metrowest Medical Center · Framingham $380
- St Vincent Hospital · Worcester $380
- North Adams Regional Hospital Corporation · North Adams $763
- Fairview Hospital · Great Barrington $803
- Cambridge Health Alliance · Cambridge $871
- Newton-Wellesley Hospital · Newton $871
- Brigham and Women's Hospital · Boston $871
- Nantucket Cottage Hospital · Nantucket $871
Insurance negotiated median for the same procedure, sorted lowest first.