CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Harrison County Community Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$255

about 0.3× the $927 Medicare rate · typically $136–$1,363

modeled estimate · not a bill or quote

What this hospital charges insurers

$145

Below the fair price — a good deal

about $110 under the fair price · 0.2× Medicare

Medicare pays $927 Fair price $255 This hospital $145 Cash price $260 Hospital's list price $400

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

One of the lower prices — 6 of 8 other MO hospitals charge more for the same procedure.

Cheapest $118 Priciest $285

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 $255 (about 0.3× the $927 Medicare rate). Harrison County Community Hospital charges insurers about $145, or about $260 in cash — below the fair price — a good deal. Located in Bethany, MO.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$145 - $1,454	16%
Blue Cross Blue Shieldmajor	$135 - $1,505	15%
Aetnamajor	$147 - $1,505	16%
Cignamajor	$126 - $1,368	14%
Humanamajor	$145 - $1,539	16%
Ambetter (Centene)	$145 - $992	16%
+ 7 smaller / regional plans	$126 - $1,368

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 260), 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 Harrison County Community 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 Harrison County Community Hospital

Compare: Upper endoscopy with biopsy at other MO hospitals

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