CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Henry Ford Health Warren Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $946
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Henry Ford Health Warren Hospital is $946. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.02x the Medicare baseline. Located in 11800 East Twelve Mile Road, Warren, MI.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$946

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%)
Insurance Median: $946 (102%)
Ins. Median: $946 (102% 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
Meridian Health Plan $392 42%
Ppom $409 44%
Medicare (plans) $873 - $965 94%
Amerihealth Vip Care $909 98%
Aetna $919 99%
Harbor Advantage Hmo $919 99%
Tricare $919 99%
Veterans Choice $919 99%
Humana $928 100%
Total Health Care $928 100%
Meridian Wellcare $965 104%
Molina Advantage $965 104%
Molina Health Link $965 104%
Ambetter / Centene $1,148 124%
Molina Market Place $1,148 124%
Phcs Ppo Great West & Mailhandlers $1,186 128%
Phcs Pos $1,243 134%
Smarthealth $1,286 139%
Phcs Ppo $1,381 149%
Aaa-Auto Insurance $1,745 188%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11800 East Twelve Mile Road, Warren, MI 48093
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals