Upper endoscopy with biopsy
Facility: Mercy Hospital Jefferson
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,110
- Cash Discount Price: $4,253
- vs. Medicare Baseline: 1.20x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $128 - $2,423 | 14% |
| Indian Health Service Contracted [320198] | $128 | 14% |
| Medicaid / KanCare | $799 | 86% |
| UnitedHealthcare | $799 - $871 | 86% |
| Aetna | $871 | 94% |
| American Health Advantage Of Mo Mcr [10473] | $871 | 94% |
| Cherokee Nation Health Serv Contracted [320066] | $871 | 94% |
| Cross Timbers Hospice [20098] | $871 | 94% |
| Dept Of Veteran Affairs Contracted [320106] | $871 | 94% |
| Elara Caring Aspire Hospice Contracted [320433] | $871 | 94% |
| Elara Caring Aspire Hospice [20433] | $871 | 94% |
| Globalhealth Contracted [320145] | $871 | 94% |
| Halo Hcr Inc Hospice Contracted [320432] | $871 | 94% |
| Halo Hcr Inc Hospice [20432] | $871 | 94% |
| Humana | $871 | 94% |
| Kindful Hospice Contracted [320434] | $871 | 94% |
| Kindful Hospice [20434] | $871 | 94% |
| Medicare (plans) | $871 - $916 | 94% |
| Mercy Hospice Okc [20252] | $871 | 94% |
| Pace Of The Ozarks Contracted [320518] | $871 | 94% |
| Qual Choice Contracted [320325] | $871 | 94% |
| Tricare | $871 | 94% |
| Hope Trust Contracted [320488] | $888 | 96% |
| Cigna | $889 | 96% |
| Provider Partners Health Plans Contracted [320450] | $960 | 104% |
| Mercy Benefit Admin Contracted [320251] | $1,050 - $1,576 | 113% |
| Mercy Benefit Admin [20251] | $1,050 - $1,576 | 113% |
| Healthscope Contracted [320182] | $1,110 | 120% |
| Medica Contracted [320239] | $1,135 | 122% |
| Centivo Contracted [320505] | $1,465 | 158% |
| Show-Me Health Administrators Contracted [320483] | $1,530 - $1,607 | 165% |
| Preferred Health Plan Contracted [320522] | $1,554 | 168% |
| Aither Health Contracted [320449] | $1,576 | 170% |
| Aither Health [20449] | $1,576 | 170% |
| Auxiant Contracted [320462] | $1,576 | 170% |
| Ebms Contracted [320493] | $1,576 | 170% |
| Edison Health Solutions Contracted [320502] | $1,576 | 170% |
| Healthlink Contracted [320179] | $1,576 | 170% |
| Imagine 360 Contracted [320494] | $1,576 | 170% |
| Reflect Health Contracted [320492] | $1,576 | 170% |
| Yuzu Health Contracted [320521] | $1,576 | 170% |