CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: St Joe Mercy Hospital System Livonia

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$73
about 0.1× the $927 Medicare rate · typically $50–$375
modeled estimate · not a bill or quote
What this hospital charges insurers
$118
Above the fair price
about $45 over the fair price · 0.1× Medicare
Medicare pays $927 Fair price $73 This hospital $118 Hospital's list price $292

How we calculate the fair BaseRate →

How this hospital compares to other MI hospitals

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

Cheapest $118 Priciest $204

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

A fair price for a Upper endoscopy with biopsy is about $73 (about 0.1× the $927 Medicare rate). St Joe Mercy Hospital System Livonia charges insurers about $118 — above the fair price. Located in Livonia, MI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $73. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

6 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 $44 - $931 5%
Blue Cross Blue Shieldmajor $44 - $1,106 5%
Aetnamajor $44 - $886 5%
Cignamajor $44 - $375 5%
Humanamajor $44 - $259 5%
Kaiser Permanentemajor $998 108%
Ambetter (Centene) $44 - $118 5%
AmeriHealth $164 - $259 18%
CareSource $1,025 111%
Clover Health $63 - $203 7%
Dean Health Plan $87 - $279 9%
Health Net $44 - $266 5%
HealthPartners $44 - $183 5%
MagnaCare $164 - $259 18%
Medical Mutual $164 - $259 18%
Meridian $44 - $203 5%
Molina $44 - $1,175 5%
MVP Health Care $87 - $279 9%
Paramount $44 - $118 5%
Presbyterian $44 - $203 5%
Priority Health $105 - $499 11%
Tufts Health Plan $44 - $183 5%
UniCare $164 - $259 18%
WellMed $63 - $203 7%
WellSense $44 - $118 5%
+ 426 smaller / regional plans $44 - $2,034
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

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Facility Profile & Credentials

  • Address: 36475 Five Mile Road, Livonia, MI 48154
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals