CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Falmouth Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$1,295
about 1.4× the $927 Medicare rate · typically $1,055–$1,460
modeled estimate · not a bill or quote
What this hospital charges insurers
$1,098
Below the fair price — a good deal
about $197 under the fair price · 1.2× Medicare
Medicare pays $927 Fair price $1,295 This hospital $1,098 Cash price $1,740 Hospital's list price $4,094

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 $1,098

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 $1,295 (about 1.4× the $927 Medicare rate). Falmouth Hospital charges insurers about $1,098, or about $1,740 in cash — below the fair price — a good deal. Located in Falmouth, MA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser 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 $549 - $1,098 59%
Blue Cross Blue Shieldmajor $581 - $1,978 63%
Harvard Pilgrim $714 - $1,428 77%
UniCare $870 94%
WellSense $1,417 - $2,835 153%
+ 4 smaller / regional plans $541 - $2,618

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Facility Profile & Credentials

  • Address: 67 & 100 Ter Heun Drive, Falmouth, MA 02540
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals