CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Memorial Hospital at Gulfport

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $1,529
Cash Discount Price: $2,429
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Memorial Hospital at Gulfport is $1,529. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,429. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.65x the Medicare baseline. Located in 4500 13Th Street, Gulfport, MS.

Cash / Self-Pay

$2,429

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,529

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: $2,429 (262%)

Insurance Median: $1,529 (165%)

Cash: $2,429 (262% of Medicare)

Ins. Median: $1,529 (165% 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
Cigna	$171 - $3,731	18%
Sas Mhg	$521 - $2,117	56%
UnitedHealthcare	$672 - $3,064	73%
Magnolia Health	$685 - $1,161	74%
Molina	$692 - $1,238	75%
Blue Cross Blue Shield	$878 - $2,776	95%
Humana	$895 - $2,499	97%
Aetna	$1,416	153%
Fox Everett	$1,509	163%
First Choice	$1,529 - $2,499	165%
Sas Non-Mhg	$1,529	165%
Mhg	$1,611	174%
Primewell	$1,857	200%
First Health	$2,499	270%
Mpcn	$2,603	281%

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 $2,429.
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 Memorial Hospital at Gulfport 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.