CMS Price Transparency Data
Upper endoscopy with biopsy
Facility: Hurley Medical Center
Billing Code: 43239 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 43239
- Insurance Median: $164
- Cash Discount Price: $437
- vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Hurley Medical Center is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $437. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.18x the Medicare baseline. Located in One Hurley Plaza, Flint, MI.
Cash / Self-Pay
$437
Average discount available for prompt cash payment at this facility.
Insurance Median
$164
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: $437 (47%)
Insurance Median: $164 (18%)
Cash: $437 (47% of Medicare)
Ins. Median: $164 (18% 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.
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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 |
|---|---|---|
| Abw Coverage No Hmo Listed [3003] | $44 - $475 | 5% |
| Aetna | $44 - $2,724 | 5% |
| Blue Cross Blue Shield | $44 - $1,053 | 5% |
| Childrens Special Health Services Alt [3009] | $44 - $475 | 5% |
| Childrens Special Healthcare Services (Cshcs) [3002] | $44 - $475 | 5% |
| Genesee County Cmh [9003] | $44 | 5% |
| Harbor Health Plan [9016] | $44 - $475 | 5% |
| Medicaid / KanCare | $44 - $475 | 5% |
| Meridian Health Plan [9007] | $44 - $475 | 5% |
| Molina Health Care [9008] | $44 - $475 | 5% |
| Molina [1071] | $44 - $908 | 5% |
| Out Of County Cmh [9010] | $44 | 5% |
| UnitedHealthcare | $44 - $1,271 | 5% |
| Jvhl Labs [1068] | $45 - $164 | 5% |
| Medicare (plans) | $45 - $908 | 5% |
| County Health Plan B [1022] | $48 | 5% |
| Key Benefit Administrators [1089] | $48 - $87 | 5% |
| Ambetter / Centene | $61 - $908 | 7% |
| Amerihealth Caritas Vip Care Plus [7025] | $61 - $908 | 7% |
| Blue Care Network Advantage [7001] | $61 - $908 | 7% |
| Freedom Health Care [7022] | $61 - $908 | 7% |
| Health Alliance Plan Senior [7003] | $61 - $908 | 7% |
| Independent Care Health Plan [7015] | $61 - $908 | 7% |
| Mclaren Advantage [7002] | $61 - $908 | 7% |
| Medica Healthcare Plan, Inc [7012] | $61 - $908 | 7% |
| Meridian Complete [7024] | $61 - $908 | 7% |
| Pacificare Of Arizona [7013] | $61 - $908 | 7% |
| Va Medical Center [1061] | $61 - $908 | 7% |
| Wellcare Health Plan [7021] | $61 - $908 | 7% |
| Zing Health [7028] | $63 - $940 | 7% |
| Humana | $65 - $914 | 7% |
| Tricare | $65 - $914 | 7% |
| Vha Office Of Community Care [1011] | $65 - $914 | 7% |
| Mclaren Health Advantage [1038] | $66 | 7% |
| Aaa Auto Insurance [8001] | $81 - $2,270 | 9% |
| Allstate Auto Insurance [8003] | $81 - $2,270 | 9% |
| Auto Owners Auto Insurance [8006] | $81 - $2,270 | 9% |
| Bristol West [8007] | $81 - $2,270 | 9% |
| Citizens Auto Insurance [8008] | $81 - $2,270 | 9% |
| Encompass Insurance [8010] | $81 - $2,270 | 9% |
| Esis [8011] | $81 - $2,270 | 9% |
| Esurance [8039] | $81 - $2,270 | 9% |
| Farm Bureau Auto Insurance [8012] | $81 - $2,270 | 9% |
| Farmers Auto Insurance [8013] | $81 - $2,270 | 9% |
| Fremont Insurance [8015] | $81 - $2,270 | 9% |
| Geico Insurance [8016] | $81 - $2,270 | 9% |
| Generic No Fault Auto [8000] | $81 - $2,270 | 9% |
| Grange Insurance [8018] | $81 - $2,270 | 9% |
| Hanover Insurance [8019] | $81 - $2,270 | 9% |
| Hartford Auto Insurance [8021] | $81 - $2,270 | 9% |
| Hastings Mutual [8022] | $81 - $2,270 | 9% |
| Kemper Insurance [8024] | $81 - $2,270 | 9% |
| Liberty Mutual [8025] | $81 - $2,270 | 9% |
| Mackinaw Administrators [8040] | $81 - $2,270 | 9% |
| Meemic Insurance [8026] | $81 - $2,270 | 9% |
| Mitchell Wcs Frankenmuth 135801 [8014] | $81 - $2,270 | 9% |
| National General Ins [8017] | $81 - $2,270 | 9% |
| Nationwide [8028] | $81 - $2,270 | 9% |
| Pioneer State Mutual Auto [8030] | $81 - $2,270 | 9% |
| Progressive Auto Insurance [8031] | $81 - $2,270 | 9% |
| Safeco-Auto [8037] | $81 - $2,270 | 9% |
| State Auto Group [8033] | $81 - $2,270 | 9% |
| State Farm Auto Insurance [8034] | $81 - $2,270 | 9% |
| Usaa [8036] | $81 - $2,270 | 9% |
| Aarp [1001] | $87 | 9% |
| Alliance Health And Life [1004] | $87 - $2,125 | 9% |
| Allied Benefit Systems [1005] | $87 - $2,724 | 9% |
| Allied Insurance [1006] | $87 - $2,125 | 9% |
| Asr Corporation [1007] | $87 - $2,125 | 9% |
| Assurant Health [1008] | $87 - $2,724 | 9% |
| Automated Benefit Services [1002] | $87 - $2,125 | 9% |
| Bankers Life [1009] | $87 - $2,125 | 9% |
| Chesterfield Resources [1012] | $87 - $2,125 | 9% |
| Cigna | $87 - $971 | 9% |
| Coresource [1016] | $87 - $2,724 | 9% |
| Geha [1019] | $87 - $2,724 | 9% |
| Generic Commercial [1000] | $87 - $2,125 | 9% |
| Globalcare [1024] | $87 - $2,125 | 9% |
| Golden Rule [1067] | $87 | 9% |
| Ibew Local 17 [1031] | $87 - $2,125 | 9% |
| Jp Farley Corporation [1033] | $87 - $2,125 | 9% |
| Luminare [1085] | $87 - $2,724 | 9% |
| Managed Health Network [1036] | $87 - $2,125 | 9% |
| Mclaren Health Plan [9006] | $87 - $475 | 9% |
| Meritain Health [1039] | $87 - $2,125 | 9% |
| Ngs [1043] | $87 - $2,125 | 9% |
| Shasta [1090] | $87 | 9% |
| Teamsters Health And Welfare Fund [1054] | $87 - $2,125 | 9% |
| United Behavioral Health [1057] | $87 - $2,125 | 9% |
| United Medical Resources [1059] | $87 | 9% |
| University Of Michigan Health Plan [1046] | $87 - $164 | 9% |
| Varipro [1092] | $87 - $2,125 | 9% |
| Zelis [1093] | $87 - $2,125 | 9% |
| Bcn Hurley Employee [6007] | $97 - $1,053 | 10% |
| Blue Care Network [6005] | $97 - $1,053 | 10% |
| Asu Risk Management [5002] | $103 | 11% |
| Generic Workers Compensation [5000] | $103 - $203 | 11% |
| Indiana Insurance [5012] | $103 | 11% |
| Medrisk [5024] | $103 | 11% |
| Mitchell Frankenmuth Workers Comp [5027] | $103 | 11% |
| One Call [5023] | $103 | 11% |
| All Savers Insurance [1073] | $121 | 13% |
| Priority Health Plan [1051] | $124 - $971 | 13% |
| Us Department Of Labor [5020] | $130 - $1,135 | 14% |
| Am First [1088] | $164 | 18% |
| Ameraplan, Inc [1069] | $164 | 18% |
| Carelon Behavioral Health [1063] | $164 | 18% |
| Caro Community Center [1010] | $164 | 18% |
| Compcare [1015] | $164 | 18% |
| County Health Plan A [1021] | $164 | 18% |
| Crime Victim Services Comm [1064] | $164 | 18% |
| Employee Benefit Logistics [1096] | $164 | 18% |
| First Health Network Generic [1079] | $164 | 18% |
| Genesee County Free Clinic [1020] | $164 | 18% |
| Gift Of Life [1023] | $164 | 18% |
| Health Partners [1074] | $164 | 18% |
| Health Scope Benefits [1082] | $164 | 18% |
| Hospice [1029] | $164 | 18% |
| Immergrun [1032] | $164 | 18% |
| Mackinaw Administrators [1034] | $164 | 18% |
| Magellan Health Services [1035] | $164 | 18% |
| Michigan Insurance Co [1040] | $164 | 18% |
| Mutual Of Omaha [1080] | $164 | 18% |
| Nippon Life Benefits [1086] | $164 - $2,724 | 18% |
| Omnicare Health Plan [1066] | $164 | 18% |
| Pace Great Lakes [1078] | $164 | 18% |
| Paramount Health Care [1044] | $164 | 18% |
| Passport Advantage [1045] | $164 | 18% |
| Phcs/Multiplan Generic [1072] | $164 | 18% |
| Pioneer State Mutual [1048] | $164 | 18% |
| Planned Administrators Inc [1049] | $164 | 18% |
| Plumbers Local 98 Insurance Fund [1091] | $164 - $2,125 | 18% |
| Safeco [1052] | $164 | 18% |
| Triwest Wps-Vapc3 [1083] | $164 - $914 | 18% |
| Upper Penninsula Health [1060] | $164 | 18% |
| Wellnet Healthcare Administrators [1097] | $164 | 18% |
| Health Alliance Plan [1025] | $174 - $908 | 19% |
| Accident Fund Of Michigan [5001] | $203 | 22% |
| Auto Owners Work Comp [5003] | $203 | 22% |
| Broadspire Insurance [5004] | $203 | 22% |
| Citizens Management [5005] | $203 | 22% |
| Compone Administrators [5006] | $203 | 22% |
| Emc Insurance Co [5018] | $203 | 22% |
| Farm Bureau Work Comp Ins [5021] | $203 | 22% |
| Gallagher Bassett [5009] | $203 | 22% |
| Hartford Work Comp Ins [5010] | $203 | 22% |
| Liberty Mutual [5013] | $203 | 22% |
| Mackinaw Administrators Work Comp [5019] | $203 | 22% |
| Michigan Municipal League [5014] | $203 | 22% |
| Nationwide Workers Compensation [5025] | $203 | 22% |
| Pioneer State Mutual Workers Comp [5026] | $203 | 22% |
| Premier Comp Solutions, Llc [5022] | $203 | 22% |
| Sedgewick [5015] | $203 | 22% |
| Travelers [5016] | $203 | 22% |
| Affirmative Insurance [8002] | $406 - $2,270 | 44% |
| American Claims Management [8004] | $406 - $2,270 | 44% |
| American Fellowship Mutual Insurance [8005] | $406 - $2,270 | 44% |
| Cincinnati Insurance Co [8038] | $406 - $2,270 | 44% |
| Dairyland Insurance [8009] | $406 - $2,270 | 44% |
| Harleysville Insurance [8020] | $406 - $2,270 | 44% |
| Horace Mann Insurance [8023] | $406 - $2,270 | 44% |
| Michigan Insurance Co Auto [8027] | $406 - $2,270 | 44% |
| Northpointe Auto Insurance [8029] | $406 - $2,270 | 44% |
| Titan Auto Insurance [8035] | $406 - $2,270 | 44% |
| Genesee County Incarcerated [1104] | $475 | 51% |
| Mclaren Michild [1070] | $475 | 51% |
| Secura [8032] | $2,270 | 245% |