CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: M Health Fairview Southdale Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$696

about 0.8× the $927 Medicare rate · typically $459–$1,052

modeled estimate · not a bill or quote

What this hospital charges insurers

$654

About the fair price

about $42 under the fair price · 0.7× Medicare

Medicare pays $927 Fair price $696 This hospital $654 Cash price $835 Hospital's list price $2,083

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

Highest price of the 9 MN hospitals we have prices for — worth calling around.

Cheapest $118 Priciest $654

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

A fair price for a Upper endoscopy with biopsy is about $696 (about 0.8× the $927 Medicare rate). M Health Fairview Southdale Hospital charges insurers about $654, or about $835 in cash — about the fair price. Located in Edina, MN.

What each insurance company pays

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

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser 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	$125 - $3,365	13%
Blue Cross Blue Shieldmajor	$106 - $1,587	11%
HealthPartners	$92 - $2,810	10%
Medica	$99 - $2,264	11%
Sanford Health Plan	$125 - $1,230	13%
Security Health Plan	$125 - $1,566	13%
UCare	$94 - $2,145	10%
WellCare	$125 - $933	13%
+ 5 smaller / regional plans	$43 - $1,879

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 835), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm M Health Fairview Southdale Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at M Health Fairview Southdale Hospital

Compare: Upper endoscopy with biopsy at other MN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.