CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Washington County Memorial Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$594

about 0.6× the $927 Medicare rate · typically $136–$1,899

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $594 Cash price $910 Hospital's list price $1,213

How we calculate the fair BaseRate →

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✓ Cigna✓ Humana AetnaKaiser 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	$353 - $1,987	38%
Blue Cross Blue Shieldmajor	$481 - $1,124	52%
Cignamajor	$526 - $1,024	57%
Humanamajor	$577 - $1,124	62%
Ambetter (Centene)	$263 - $512	28%
+ 1 smaller / regional plan	$481 - $937

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 910), 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 Washington County Memorial Hospital 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 Washington County Memorial Hospital

Compare: Upper endoscopy with biopsy at other MO hospitals

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