CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Trinity Health Livingston Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $94
  • Cash Discount Price: $4,173
  • vs. Medicare Baseline: 0.10x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Trinity Health Livingston Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,173. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.10x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$4,173

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $4,173 (450%)
Insurance Median: $94 (10%)
Cash: $4,173 (450% of Medicare)
Ins. Median: $94 (10% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $926.63 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Albany County Correctional Facility $44 5%
Ambetter / Centene $44 5%
Amish Mennonite $44 5%
Ascension St. Vincent Public Safety Medical $44 5%
Bccp $44 5%
Blue Cross Blue Shield $44 - $1,378 5%
Bmc Healthnet $44 5%
Breast Grant-Connecticut $44 5%
Broward County Dept Of Health $44 5%
California Health And Wellness $44 5%
Cardinal Innovations Lme $44 5%
Care Connections Of Northern Iowa $44 5%
Care Oregon Ohp $44 5%
Cencal Health Plan $44 5%
Cenpatico $44 5%
Chhuny $44 5%
Childrens Comm Health Plan $44 5%
Childrens Medical Services Title 19 $44 5%
Cigna $44 - $88 5%
City Of Philadelphia $44 5%
Cmh Allegan County $44 5%
Cmh Ausable Valley $44 5%
Cmh Barry County $44 5%
Cmh Bay-Arenac County $44 5%
Cmh Berrien County $44 5%
Cmh Cass County $44 5%
Cmh Central Mi County $44 5%
Cmh Clinton-Eaton-Ingham County $44 5%
Cmh Detroit Wayne Integrated Health Network $44 5%
Cmh Genesee County $44 5%
Cmh Ionia County $44 5%
Cmh Jackson County/Lifeways $44 5%
Cmh Kalamazoo $44 5%
Cmh Kent County $44 5%
Cmh Lenawee County $44 5%
Cmh Livingston County $44 5%
Cmh Macomb $44 5%
Cmh Misc $44 5%
Cmh Monroe County $44 5%
Cmh Montcalm County $44 5%
Cmh Muskegon County $44 5%
Cmh Newaygo County $44 5%
Cmh North Country $44 5%
Cmh Northern Lakes County $44 5%
Cmh Oakland County $44 5%
Cmh Ottawa County $44 5%
Cmh Van Buren County $44 5%
Cmh Washtenaw County $44 5%
Cmh Wayne County/Carelink $44 5%
Cmh Wayne Cty/Com Liv Svcs $44 5%
Cmh West Mi County $44 5%
Community Benefit Health $44 5%
Community Care Behavorial Health $44 5%
Community Care Partners $44 5%
Community Health Choice $44 5%
Connections Csp $44 5%
County Coroner $44 5%
County Funding Generic $44 5%
Covid19 Hrsa Uninsured Testing And Treatment Fund $44 5%
Dean Wi Badgercare $44 5%
Delaware County Department Of Health $44 5%
Delaware First Health $44 5%
Delta Dental Nj $44 5%
Dph Tb Program $44 5%
Dscc $44 5%
Eastpointe Lme $44 5%
Family Health Network $44 5%
Freedom First Healthcare $44 5%
Fresno County Ccs $44 5%
Ghc Scw Wi Badgercare $44 5%
Harbor Health $44 5%
Health Safety Net $44 5%
Healthy Blue Ne $44 5%
Hennepin Health $44 5%
Humana $44 - $698 5%
Id County Ada $44 5%
Id County Canyon $44 5%
Id County Cat Fund $44 5%
Id County Other $44 5%
Id County Payette $44 5%
Idaho Dept Health And Wellfare $44 5%
Idaho Womens Health Check $44 5%
Indiana Breast Cervical Cancer $44 5%
Inland Empire Health Plan $44 5%
Intercommunity Health Ohp $44 5%
Iowa Total Care $44 5%
Jai Medical System $44 5%
Kern Family Health Plan $44 5%
Keystone First $44 5%
Keystone First Chip $44 5%
La Care Health Plan $44 5%
Lakeland Care Inc $44 5%
Managed Health Services - Indiana $44 5%
Maryland Breast & Cervical Program $44 5%
Maryland Healthy Smiles - Scion Dental $44 5%
Maryland Physicians Care $44 5%
Massachusetts Behavioral Health Partnership $44 5%
Mdwise $44 5%
Medi-Cal $44 5%
Medi-Cal Healthnet $44 5%
Medicaid / KanCare $44 - $517 5%
Medstar Dc Healthy Family $44 5%
Medstar Md Health Choice $44 5%
Mo Home State Health Plan $44 5%
Molina Centennial Care $44 5%
Nascentia Health Options $44 5%
Nebraska Total Care $44 5%
New York Cancer Services Program $44 5%
Nextlevel Health $44 5%
Oregon Screenwise $44 5%
Pace Of Southwest Michigan $44 - $60 5%
Paramount Advantage $44 5%
Parkland Community Health Plan $44 5%
Partners Behavioral Lme $44 5%
Peach State Healthplan $44 5%
Philadelphia County Funding $44 5%
Presbyterian Centennial Care $44 5%
Prestige Health Choice $44 5%
Priority Partners $44 5%
Robert F Sing Program $44 5%
Rx 340B Pass Along $44 5%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $44 5%
Rx Medi-Cal $44 5%
Rx Meridian Rx $44 5%
Ryan White Florida Mssrp $44 5%
Sandhills Center Lme $44 5%
Screening For Life $44 5%
St Joseph County Hlth Dpt $44 5%
Stephenson Cty Health $44 5%
Sunshine State Health Plan $44 5%
Superior Health $44 5%
Tenncare $44 5%
Texas Children'S Health Plan $44 5%
Trillium Community Ohp $44 5%
Tufts Health Public Plans $44 5%
UnitedHealthcare $44 - $933 5%
Vaya Health Lme $44 5%
Washtenaw Health Plan $44 5%
Wellsense Health Plan $44 5%
Wi Womens Wellness $44 5%
Aetna $46 - $888 5%
Ally Align Care Adv $60 6%
American Health Advantage Of Idaho $60 6%
American Health Plan $60 6%
Aurora Special Needs $60 6%
Blue Care Network Advantage $60 - $888 6%
Blue Shield - De (Highmark) Medciare Advantage $60 6%
Care Dimensions $60 6%
Care Improvement Plus $60 6%
Care Resources Pace $60 6%
Careplus Health Plans $60 6%
Cca Senior Care Options $60 6%
Central Valley Medical Services Corp Pace $60 6%
Champion Health Plan Mcr Advantage $60 6%
Clear Spring Health $60 6%
Clover Health $60 6%
Commonwealth Care Alliance $60 6%
Community Pace At Home $60 6%
Eddy Senior Care-Pace $60 6%
Eddy Seniorcare Pace $60 6%
Elementcare $60 6%
Evercare $60 6%
Everence $60 6%
Gateway Health Plan $60 6%
Genesys Pace Of Genesee County $60 6%
Georgia Health Advantage $60 6%
Gold Advantage $60 6%
Gpa Croell Redi Mix $60 6%
Health America Advantra $60 6%
Highmark Health Options Dual Plan $60 6%
Hope Select Pace $60 6%
Horizon Nj Total Care $60 6%
Hudson Headwaters Pace $60 6%
Huron Valley Pace $60 - $860 6%
Innovative Integrated Health Community Plans $60 6%
Iowa Health Advantage $60 6%
Johns Hopkins Advantage Md $60 6%
Lasso Healthcare Msa $60 6%
Life St Marys Pace $60 6%
Lifecircles Pace $60 6%
Longevity Health Plan $60 6%
Martins Point Generations Advantage $60 6%
Mass General Brigham Mcr Adv $60 6%
Medicare (plans) $60 - $906 6%
Medipak Advantage $60 6%
Mercy Life $60 6%
Mercyone Cedar Valley $60 6%
Meridian Complete $60 6%
Michigan Complete Health $60 6%
Nascentia Health Plus $60 6%
New Centry Health Careplus $60 6%
Osu Prime Care Advantage $60 6%
Pace Cny $60 6%
Pace Iowa Immanuel Pathways $60 6%
Pace Southeast $60 6%
Pace-Trinity Health $60 6%
Peak Pace Solutions $60 6%
Perennial Advantage $60 6%
Preferred Care Partners $60 6%
Presbyterian Senior Plan $60 6%
Provider Partners Health Plan Of Illinois $60 6%
Provider Partners Health Plan Of Indiana $60 6%
Pruitthealth Premier $60 6%
Reliance Community Care Partners Care Resources Pace $60 6%
Rx Allwin $60 6%
Rx Grane Grnmedd $60 6%
Rx Retiree Rx Care $60 6%
Scan Health Plan Mcr Ipa Meritage Oon $60 6%
Secure Horizons Ma Pffs $60 6%
Serenity Pace $60 6%
Siouxland Pace $60 6%
Solis Health Plans $60 6%
Sunnyview-Pace Finance Dept $60 6%
Texan Plus $60 6%
The Health Plan $60 - $698 6%
Thome Pace $60 6%
Todays Options $60 6%
Tribute Health Plans $60 6%
Um Health Advantage $60 6%
Union Health Service $60 6%
Welbe Health $60 6%
Wellmed $60 6%
Align Senior Care $61 - $906 7%
Veterans Administration $61 7%
Champva $64 7%
Tricare $64 7%
Triwest Health Alliance $64 7%
Us Family Health Plan $64 7%
Veterans Eval Services $64 7%
Cca - Zing Health $66 - $959 7%
Longevity Ipa Of Michigan Llc Health Plan Isnp $68 - $1,021 7%
U Of M Health Plan $76 - $754 8%
1199 National Benefit Fund $82 9%
Allied National Global Care $82 9%
Asrm - Reliance Standard Life Insurance $82 9%
Christian Care Ministry $82 9%
Dean Health $82 9%
Fallon Health $82 9%
Family Life Insurance Company $82 9%
International Benefit Administrators $82 9%
Lifetime Benefit Solutions $82 9%
Manhattan Life $82 9%
Meritain $82 9%
Molina Marketplace $82 - $1,177 9%
Multiplan $82 9%
Mvp $82 9%
Pai $82 9%
Pan-American Life $82 9%
Phcs $82 9%
Trinity Health Share $82 9%
Wellpath $82 - $1,404 9%
American Postal Workers Secondary $88 9%
Partners Direct Health - Brio $88 9%
Claimdoc $94 10%
Kent County Jail $94 10%
Muskegon County Jail $94 10%
Wc Accident Fund $98 11%
Wc Advantage $98 11%
Wc Aig $98 11%
Wc Allied $98 11%
Wc Amerisure $98 11%
Wc Amtrust $98 11%
Wc Asu Risk Mgt $98 11%
Wc Berkley Admin $98 11%
Wc Broadspire $98 11%
Wc Bunch & Associates $98 11%
Wc Ccmsi $98 11%
Wc Emc Insurance Company $98 11%
Wc Esis $98 11%
Wc Fcci $98 11%
Wc Federated $98 11%
Wc Gallagher Bassett $98 11%
Wc Genex Care For Ohio $98 11%
Wc Guard Insurance Company $98 11%
Wc Hartford $98 11%
Wc Liberty Mutual $98 11%
Wc Meijers $98 11%
Wc Michigan $98 11%
Wc Mitchell Frankenmuth $98 11%
Wc Pma $98 11%
Wc Sedgwick $98 11%
Wc Sentry $98 11%
Wc Travelers $98 11%
Wc Tristar $98 11%
Wc Walmart $98 11%
Wc Zurich $98 11%
Blue Care Network $99 - $1,378 11%
Andrie Inc $103 11%
East Greenbush Central School District $103 11%
Genex Wc $103 11%
Healthsmart Workers Comp $103 11%
Jag Source $103 11%
New York State Insurance Fund $103 11%
Njm Insurance Group $103 11%
Rx Heatlhcomp $103 11%
Rx Restat $103 11%
Rx Saif Opdp Wc $103 11%
Rx Worker'S Comp $103 11%
Wc Ace $103 11%
Wc Acs Federal Employees $103 11%
Wc Acuity $103 11%
Wc Aegis $103 11%
Wc Aims $103 11%
Wc Alaska National Ins $103 11%
Wc Align Network $103 11%
Wc Am Trust N America $103 11%
Wc American Claims Mgmt $103 11%
Wc Benetech $103 11%
Wc Broward County $103 11%
Wc California State Comp Ins $103 11%
Wc California State Ins Fund $103 11%
Wc Capitol Area Health Consortium $103 11%
Wc Chartis $103 11%
Wc Chubb $103 11%
Wc Cirma $103 11%
Wc City Of Albany $103 11%
Wc City Of Sioux City $103 11%
Wc Claims Mgmt Inc $103 11%
Wc Cna $103 11%
Wc Comp One Admin C/O Manageability $103 11%
Wc Compone Admin $103 11%
Wc Corvel $103 11%
Wc Ct Healthcare Trust $103 11%
Wc Donegal Insurance Group $103 11%
Wc Employee Mutual $103 11%
Wc Enablecomp $103 11%
Wc Encore Health Network $103 11%
Wc Erie $103 11%
Wc Evolutions $103 11%
Wc Fed Ex $103 11%
Wc Federal Black Lung $103 11%
Wc Finley Occupational Health $103 11%
Wc First Agency/Occunet $103 11%
Wc Ford Motor $103 11%
Wc Fresno Unified Emp $103 11%
Wc General Motors $103 11%
Wc Generic $103 11%
Wc Great West Casualty $103 11%
Wc Guarantee Insurance $103 11%
Wc Hab $103 11%
Wc Hastings $103 11%
Wc Health Management $103 11%
Wc Heritage Summit $103 11%
Wc Hireright $103 11%
Wc Horizon $103 11%
Wc Icw Group $103 11%
Wc Idaho State Ins Fund $103 11%
Wc Intercare Insurance $103 11%
Wc Intermountain $103 11%
Wc Johns Eastern $103 11%
Wc Kemberton $103 11%
Wc Key Ins & Benefit Solutions $103 11%
Wc Mac Risk Management $103 11%
Wc Massachusetts $103 11%
Wc Mdia $103 11%
Wc Meadowbrook Claim $103 11%
Wc Medical Administrators $103 11%
Wc Memic $103 11%
Wc Mercy Workcare $103 11%
Wc Michigan Millers Mutual $103 11%
Wc Mra $103 11%
Wc Nationwide $103 11%
Wc Nca Comp $103 11%
Wc New York $103 11%
Wc New York Special Funds $103 11%
Wc North American Rishces $103 11%
Wc Northeast Health $103 11%
Wc Notre Dame $103 11%
Wc Novanet $103 11%
Wc O'Hara Corp $103 11%
Wc Occ Health Allen $103 11%
Wc Ohio Bureau $103 11%
Wc One Call Medical $103 11%
Wc Paradigm $103 11%
Wc Peerless $103 11%
Wc Praxis Health Network $103 11%
Wc Price Chopper $103 11%
Wc Procura Management $103 11%
Wc Qualcare $103 11%
Wc Quiktrip $103 11%
Wc Reny Company $103 11%
Wc Rev Claims $103 11%
Wc Risico $103 11%
Wc Rural Mutual $103 11%
Wc Saif Oregon $103 11%
Wc Secura $103 11%
Wc Sheakley Unicomp $103 11%
Wc Smile Lodge $103 11%
Wc Society $103 11%
Wc Srs $103 11%
Wc Taconic (Mro) $103 11%
Wc Taconic Farms $103 11%
Wc Triad Group $103 11%
Wc Troy Ny $103 11%
Wc Tyson $103 11%
Wc Unified Health Services $103 11%
Wc United Heartland $103 11%
Wc Us Dept Of Labor $103 11%
Wc Velocity $103 11%
Wc West Bend $103 11%
Wc West Bend Mutual/Argent $103 11%
Wc Winnebago Industries $103 11%
Wc Yankee Trails $103 11%
Wc York Risk $103 11%
Wc Zenith $103 11%
Blue Benefit Administrators Of Massachusetts $109 - $1,378 12%
Blue Distinction Transplant $109 - $1,378 12%
Blue Shield - Ca $109 - $1,378 12%
Blue Shield - Id (Regence) $109 - $1,378 12%
Blue Shield - Ny Highmark Northeastern $109 - $1,378 12%
Blue Shield - Ny Highmark Western $109 - $1,378 12%
Blue Shield - Pa (Highmark) $109 - $1,378 12%
Blue Shield - Wa (Regence) $109 - $1,378 12%
Oscar $133 14%
Bcccp-Michigan $141 - $572 15%
Priority Health $142 - $690 15%
Mclaren Health $146 16%
Asr Health Benefits $183 - $945 20%
Hap $183 - $1,036 20%
Varipro $183 - $945 20%
Access Health $184 - $698 20%
Acclaim $184 - $698 20%
Administrative Concepts $184 - $698 20%
Allegeant $184 - $698 20%
Allied Benefit Systems $184 - $698 20%
Ameriben $184 - $698 20%
American Family $184 - $698 20%
American Healthcare Alliance $184 - $698 20%
American National $184 - $698 20%
American Republic $184 - $698 20%
Amerihealth $184 - $698 20%
Aultcare $184 - $698 20%
Automated Benefit Services $184 - $698 20%
Auxiant $184 - $698 20%
Benefit Administrative Systems,Llc $184 - $698 20%
Boon Chapman $184 - $698 20%
Cam Administrative Services $184 - $698 20%
Christian Brother Services $184 - $698 20%
Christian Brothers Holy Cross $184 - $698 20%
Claimchoice Adminstrators $184 - $698 20%
Comprehensive Benefits $184 - $698 20%
Consociate $184 - $698 20%
Continental Life Insurance $184 - $698 20%
Coventry $184 - $698 20%
Custom Benefit Administrators $184 - $698 20%
Cypress Benefit Administrators $184 - $698 20%
Employee Benefit Concepts $184 - $698 20%
Employee Benefit Management $184 - $698 20%
Enterprise Group Planning $184 - $698 20%
First Health $184 - $698 20%
Forest County Potawatomi $184 - $698 20%
Freedom Life Insurance Company $184 - $698 20%
Group Administrators $184 - $698 20%
Group Marketing Services $184 - $698 20%
Group Pension Administrators $184 - $698 20%
Guardian $184 - $698 20%
Health America $184 - $698 20%
Health Choices $184 - $1,378 20%
Health Smart $184 - $698 20%
Healthcare Management Admin $184 - $698 20%
Healthez $184 - $698 20%
Healthgram $184 - $698 20%
Healthscope $184 - $698 20%
Insight $184 - $698 20%
Intercare $184 - $698 20%
Jfp Benefit Management $184 - $698 20%
Jp Farley Corporation $184 - $698 20%
Key Benefit Administrator $184 - $698 20%
Liberty Union Life Assurance Co $184 - $698 20%
Lucent Health $184 - $698 20%
Luminare Health $184 - $698 20%
Luminare Health (Detroit) $184 - $698 20%
Magnacare $184 - $698 20%
Medben $184 - $698 20%
Medcost $184 - $698 20%
Medical Mutual $184 - $698 20%
Mutual Health Services $184 - $698 20%
Mutual Of Omaha $184 - $698 20%
Ncas $184 - $698 20%
Nippon Life Ins $184 - $698 20%
Nova $184 - $698 20%
Painters Union Insurance Fund $184 - $698 20%
Physicians Mutual $184 - $698 20%
Plumbers Local 98 Insurance Fund $184 - $698 20%
Prairie States $184 - $698 20%
Preferred One $184 - $698 20%
Primary Physician Care $184 - $698 20%
Professional Benefit Administrators $184 - $698 20%
Secureone Preferred United Plans $184 - $698 20%
Siho Insurance Services $184 - $698 20%
Sisco Benefits $184 - $698 20%
The Loomis Company $184 - $698 20%
Trustmark Small Business Benefits $184 - $698 20%
Unicare $184 - $698 20%
Unified Group Services $184 - $698 20%
Us Health And Life $184 - $698 20%
Valenz $184 - $698 20%
Webtpa $184 - $698 20%
Western & Southern Financial Group $184 - $698 20%
Wps $184 - $698 20%
Health Partners $256 - $1,036 28%
Tufts Health Plan $256 - $1,036 28%
Hospice Of Lansing $888 96%
Angela Hospice $907 98%
Caresource $945 102%
Bcn Domestic $1,378 149%
Kaiser Domestic $1,378 149%
Health Cost Solutions $1,404 152%
Vitalcore $1,404 152%
Employee Benefit Logistic $2,038 220%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 620 Byron Rd, Howell, MI 48843
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals