CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Singing River Health System

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $1,103
Cash Discount Price: $939
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Singing River Health System is $1,103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $939. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.19x the Medicare baseline. Located in 2809 Denny Av, Pascagoula, MS.

Cash / Self-Pay

$939

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,103

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: $939 (101%)

Insurance Median: $1,103 (119%)

Cash: $939 (101% of Medicare)

Ins. Median: $1,103 (119% 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
UnitedHealthcare	$809 - $1,294	87%
Aetna	$825 - $1,831	89%
Humana	$825	89%
Blue Cross Blue Shield	$833	90%
Cigna	$841 - $1,547	91%
Shared Health	$849	92%
Wellcare	$849	92%
Singing River Health System Employees	$993	107%
Ambetter / Centene	$1,213	131%
Molina Healthcare Of Ms	$1,294	140%
First Choice	$1,416	153%
Mississippi Physicians Care Network	$1,456	157%
First Choice Preferred Pricing	$1,497	162%
90 Degree Benefits	$1,537	166%

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 $939.
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 Singing River Health System 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.