CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Houlton Regional Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$508
about 0.5× the $927 Medicare rate · typically $191–$1,671
modeled estimate · not a bill or quote
What this hospital charges insurers
$452
Below the fair price — a good deal
about $56 under the fair price · 0.5× Medicare
Medicare pays $927 Fair price $508 This hospital $452 Cash price $893 Hospital's list price $940

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

On the higher side — 7 of 8 other ME hospitals charge less.

Cheapest $133 Priciest $477

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

A fair price for a Upper endoscopy with biopsy is about $508 (about 0.5× the $927 Medicare rate). Houlton Regional Hospital charges insurers about $452, or about $893 in cash — below the fair price — a good deal. Located in Houlton, ME.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 $893 96%
Blue Cross Blue Shieldmajor $436 - $792 47%
Aetnamajor $456 49%
Cignamajor $855 92%
WellCare $452 49%
+ 2 smaller / regional plans $479 - $827
Government programs also on file: Military & VA.

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Facility Profile & Credentials

  • Address: 20 Hartford Street, Houlton, ME 04730
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals