CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$987

about 1.1× the $927 Medicare rate · typically $965–$1,047

modeled estimate · not a bill or quote

What this hospital charges insurers

$985

About the fair price

about $2 under the fair price · 1.1× Medicare

Medicare pays $927 Fair price $987 This hospital $985 Cash price $1,988 Hospital's list price $3,096

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 $985

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 $987 (about 1.1× the $927 Medicare rate). Essentia Health St Marys - Detroit Lakes charges insurers about $985, or about $1,988 in cash — about the fair price. Located in Detroit Lakes, MN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$985 - $2,601	106%
Blue Cross Blue Shieldmajor	$607 - $2,353	66%
Aetnamajor	$2,632	284%
Cignamajor	$2,272	245%
HealthPartners	$985 - $2,272	106%
Medica	$985 - $2,474	106%
Sanford Health Plan	$1,328 - $1,660	143%
Security Health Plan	$985	106%
UCare	$985 - $2,037	106%
+ 12 smaller / regional plans	$874 - $2,663

Government programs also on file: Medicare.

Excludes 2 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 1,988), 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 Essentia Health St Marys - Detroit Lakes 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 (%)

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Other Procedures at Essentia Health St Marys - Detroit Lakes

Compare: Upper endoscopy with biopsy at other MN hospitals

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