CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Metrowest Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$999
about 1.1× the $927 Medicare rate · typically $589–$1,691
modeled estimate · not a bill or quote
What this hospital charges insurers
$380
Below the fair price — a good deal
about $619 under the fair price · 0.4× Medicare
Medicare pays $927 Fair price $999 This hospital $380

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Lowest price of the 9 MA hospitals we have prices for — a strong deal.

Cheapest $380 Priciest $972

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 $999 (about 1.1× the $927 Medicare rate). Metrowest Medical Center charges insurers about $380 — below the fair price — a good deal. Located in Framingham, 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

✓ Aetna✓ Cigna UnitedHealthcareBlue Cross Blue ShieldHumanaKaiser 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
Aetnamajor $4,898 529%
Cignamajor $3,913 - $13,614 422%
Health Net $380 41%
+ 1 smaller / regional plan $380
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 115 Lincoln Street, Framingham, MA 01701
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals