CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Moberly Regional Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,717
  • Cash Discount Price: $8,648
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Moberly Regional Medical Center is $1,717. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,648. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.85x the Medicare baseline. Located in 1515 Union Ave, Moberly, MO.
Cash / Self-Pay
$8,648

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,717

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: $8,648 (933%)
Insurance Median: $1,717 (185%)
Cash: $8,648 (933% of Medicare)
Ins. Median: $1,717 (185% 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
Veterans Eval Services $319 34%
Medicaid / KanCare $799 - $1,319 86%
Tricare $916 99%
Medicare (plans) $957 103%
Node Va $973 105%
UnitedHealthcare $973 - $24,502 105%
Blue Cross Blue Shield $977 - $11,402 105%
Node Devoted Health Mcr Adv $1,005 108%
Centurion Correctional $1,216 131%
Corizon $1,216 131%
Us Department Of Labor $1,216 131%
Home State Health Plan $1,319 - $1,800 142%
Pathway/Pathway X $1,396 151%
Healthscope Benefits $1,635 176%
Naphcare $1,849 200%
Blue Preferred $1,932 208%
Healthlink $3,060 - $3,400 330%
Blue Access $4,588 495%
United Behavioral Health Mcd $6,406 691%
Self Pay $8,648 933%
Cigna $9,993 1078%
Access Health Services, Llc $20,819 2247%
Aetna $21,075 - $25,624 2274%
Blue Traditional $22,898 2471%
Multiplan Primary $24,022 2592%
Coventry Wc $25,624 2765%
Multiplan $25,944 2800%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 Union Ave, Moberly, MO 65270
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals