CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Parkland Health Center - Bonne Terre

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $1,775
Cash Discount Price: $3,885
vs. Medicare Baseline: 1.92x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Parkland Health Center - Bonne Terre is $1,775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,885. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.92x the Medicare baseline. Located in 7245 Raider Road, Bonne Terre, MO.

Cash / Self-Pay

$3,885

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,775

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: $3,885 (419%)

Insurance Median: $1,775 (192%)

Cash: $3,885 (419% of Medicare)

Ins. Median: $1,775 (192% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cox Health Systems Insurance Company [220]	$754 - $1,508	81%
Health Alliance [224]	$754 - $1,508	81%
Allied Benefits [498]	$795 - $1,590	86%
Hope Trust [806]	$795 - $1,590	86%
Cigna	$871 - $1,945	94%
Healthscope Benefits [258]	$891 - $2,823	96%
Humana	$912 - $1,945	98%
Blue Cross Blue Shield	$961 - $2,402	104%
Cox Health [757]	$961 - $1,945	104%
Devoted Health Plan [847]	$961 - $1,945	104%
Essence Healthcare [221]	$961 - $1,945	104%
Medica [662]	$961 - $1,945	104%
Medicare (plans)	$961 - $1,945	104%
Apwu Health Plan [216]	$962 - $1,925	104%
Nalc Health Benefit Plan [242]	$962 - $1,925	104%
Priority Health [648]	$962 - $1,925	104%
Healthcare Sol Mercy [609]	$1,028 - $2,056	111%
Med-Pay [480]	$1,028 - $2,056	111%
Medica [661]	$1,097 - $2,194	118%
Phcs [244]	$1,097 - $2,194	118%
Consociate [478]	$1,775 - $4,402	192%
Sarah Bush Lincoln [636]	$1,775 - $4,402	192%
Aetna	$1,945	210%
UnitedHealthcare	$1,945 - $2,823	210%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,885.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 43239.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Parkland Health Center - Bonne Terre is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 43239.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.