CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Poplar Bluff Regional Medical Center

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $1,223
  • Cash Discount Price: $6,886
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Poplar Bluff Regional Medical Center is $1,223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,886. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.32x the Medicare baseline. Located in 3100 Oak Grove Road, Poplar Bluff, MO.
Cash / Self-Pay
$6,886

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,223

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: $6,886 (743%)
Insurance Median: $1,223 (132%)
Cash: $6,886 (743% of Medicare)
Ins. Median: $1,223 (132% 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
Medicaid / KanCare $297 - $6,558 32%
Veterans Eval Services $319 34%
Blue Cross Blue Shield $840 - $8,493 91%
Node Champva $916 99%
Tricare $916 99%
Medicare (plans) $957 103%
Node United Behavioral Health Mcr Adv $957 103%
Humana $967 104%
Node Hospice Non Par Agree $973 105%
Node Va $973 105%
UnitedHealthcare $973 - $17,642 105%
Node Ahs Mcr Adv $996 107%
Node Devoted Health Mcr Adv $1,005 108%
Node Pphp Mcr Adv $1,101 119%
Centurion Correctional $1,216 131%
Us Department Of Labor $1,216 131%
Naphcare $1,849 200%
Home State Exchange $2,432 262%
W W Wood $2,432 262%
Blue Access $3,389 366%
Self Pay $7,870 849%
Cigna $17,773 - $26,233 1918%
Evolutions Healthcare $17,871 1929%
Tyson Foods $18,035 1946%
Access Health Services, Llc $18,691 2017%
First Health $19,675 2123%
Healthlink $20,495 2212%
Parker Hannifin $22,954 2477%
Blue Traditional $24,252 2617%
Coventry Wc $26,233 2831%
Municipal Health $26,233 2831%
Multiplan $28,528 3079%
Phcs $28,528 3079%
Compresults Wc $29,512 3185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Oak Grove Road, Poplar Bluff, MO 63901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals