CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: St Joseph Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$1,317

about 1.4× the $927 Medicare rate · typically $520–$1,984

modeled estimate · not a bill or quote

What this hospital charges insurers

$972

Below the fair price — a good deal

about $345 under the fair price · 1.0× Medicare

Medicare pays $927 Fair price $1,317 This hospital $972 Cash price $903 Hospital's list price $2,438

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

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

Cheapest $118 Priciest $972

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

A fair price for a Upper endoscopy with biopsy is about $1,317 (about 1.4× the $927 Medicare rate). St Joseph Medical Center charges insurers about $972, or about $903 in cash — below the fair price — a good deal. Located in Kansas City, MO.

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	$904 - $2,438	98%
Blue Cross Blue Shieldmajor	$898 - $1,672	97%
Aetnamajor	$904 - $2,438	98%
Cignamajor	$904	98%
+ 7 smaller / regional plans	$904 - $1,808

Government programs also on file: Medicare, Medicaid, Military & VA.

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 903), 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 St Joseph Medical Center 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 St Joseph Medical Center

Compare: Upper endoscopy with biopsy at other MO hospitals

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