CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Henry Ford Allegiance Health

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $327
  • Cash Discount Price: $182
  • vs. Medicare Baseline: 0.35x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Henry Ford Allegiance Health is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $182. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.35x the Medicare baseline. Located in 205 N East Ave, Jackson, MI.
Cash / Self-Pay
$182

Average discount available for prompt cash payment at this facility.

Insurance Median
$327

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: $182 (20%)
Insurance Median: $327 (35%)
Cash: $182 (20% of Medicare)
Ins. Median: $327 (35% 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

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

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

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $69 - $1,696 7%
Hap Caresource $69 - $947 7%
Mclaren $69 7%
Meridian Health Plan Of Mi $69 - $1,279 7%
Priority Health $69 - $1,397 7%
Aetna $72 - $3,837 8%
Mclaren Health Plan Inc. $87 - $333 9%
Meridian $87 - $235 9%
Molina $91 - $543 10%
Priority $92 - $333 10%
Humana $108 - $966 12%
Hap $109 - $1,179 12%
Bcn $128 - $947 14%
Cca Health Mi $128 - $333 14%
Health Alliance Plan Of Michigan $128 - $333 14%
Thomas Pace $128 - $947 14%
Vaccn $132 14%
United Behavioral Health, Inc. $139 - $360 15%
Vitalcore Physicians Group Of Mi $167 - $2,113 18%
Frontpath $414 - $1,712 45%
Cofinity $429 46%
Cigna $460 - $1,697 50%
Veterans Evaluation Services $755 81%
Molina Mi Health Link $823 89%
UnitedHealthcare $823 - $1,407 89%
Cca Health Michigan $947 102%
Mclaren Health $947 - $955 102%
Jackson County Offiice Of The Sheriff $989 107%
Immergrun Inc $1,141 123%
University Of Michigan $1,331 144%
Cofinity Group Health $1,712 185%
Multiplan, Inc. $1,712 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 205 N East Ave, Jackson, MI 49201
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals