CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Glacial Ridge Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $809
Cash Discount Price: $827
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Glacial Ridge Hospital is $809. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $827. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.87x the Medicare baseline. Located in 10 4Th Avenue Southeast, Glenwood, MN.

Cash / Self-Pay

$827

Average discount available for prompt cash payment at this facility.

Insurance Median

$809

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: $827 (89%)

Insurance Median: $809 (87%)

Cash: $827 (89% of Medicare)

Ins. Median: $809 (87% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Triwest - All Plans	$403 - $428	43%
Blue Cross Blue Shield	$415 - $2,064	45%
Medica Mcare Adv	$441 - $532	48%
Medica Msho	$441 - $532	48%
Medica Mcaid	$472 - $724	51%
Medica Comm - All Other Plans	$809 - $974	87%
Preferred One Pic/Pas	$965 - $1,163	104%
Multiplan - All Plans	$1,037 - $1,249	112%
Preferred One Ppo - All Other Plans	$1,056 - $1,272	114%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $827.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Glacial Ridge Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.