Upper endoscopy with biopsy
Facility: Liberty Hospital
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,101
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.19x 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 | $141 - $3,950 | 15% |
| Cigna | $732 - $805 | 79% |
| Aetna | $805 - $3,680 | 87% |
| UnitedHealthcare | $805 - $1,327 | 87% |
| Medicare (plans) | $813 - $885 | 88% |
| Humana | $821 - $4,497 | 89% |
| Healthy Blue | $863 | 93% |
| Ambetter / Centene | $1,022 | 110% |
| Home State Health | $1,181 | 127% |
Consumer Guidance & Cost Commentary
Liberty Hospital, located at 2525 Glenn Hendren Dr in Liberty, Missouri, performed an upper endoscopy with biopsy. While the facility is a voluntary non-profit acute care hospital with a rating of 2, the specific pricing data for cash payments is not available in the current report. However, the median negotiated rate for this procedure is $1,101, which represents a markup of 1.2 times the Medicare amount of $926.63. This procedure is covered by 9 different payers, with allowed amounts ranging from a low of $141 with Blue Cross Blue Shield to a high of $3,950 with the same carrier.
For patients with high-deductible plans, the available data suggests that paying cash directly could be more cost-effective than relying on insurance, as the negotiated rates for many commercial plans exceed the potential cash price. It is important to verify if the hospital offers self-pay or prompt-pay discounts, which can significantly reduce the final bill by bypassing administrative processing fees. Additionally, patients should request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered. Disputing these errors via certified mail to the billing supervisor is the most effective way to ensure the final charge reflects the true cost of care.