CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Merit Health Natchez

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $926
  • Cash Discount Price: $5,443
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Merit Health Natchez is $926. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,443. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 1.00x the Medicare baseline. Located in 52 Sergeant Prentiss Drive, Natchez, MS.
Cash / Self-Pay
$5,443

Average discount available for prompt cash payment at this facility.

Insurance Median
$926

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: $5,443 (587%)
Insurance Median: $926 (100%)
Cash: $5,443 (587% of Medicare)
Ins. Median: $926 (100% 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.

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
Veterans Eval Services $315 34%
Advanced Health Systems $521 56%
Blue Cross Blue Shield $542 58%
Medicaid / KanCare $714 - $4,611 77%
UnitedHealthcare $714 - $4,611 77%
Cigna $715 77%
Magnolia Mcd Chip $722 78%
Caresource Truecare $729 79%
Molina Chip $772 83%
First Choice $849 - $21,167 92%
Medicare (plans) $849 92%
Node Magnolia Mcr Adv $849 92%
Node Vantage Mcr Adv $849 92%
Tricare $858 93%
Node First Choice Ice $863 93%
Node Hospice Non Par Agree $863 93%
Node Va $863 93%
Node Devoted Health Mcr Adv $866 93%
Node First Choice American Health Of Ms Mcr Adv $866 93%
Node Molina $866 93%
Node Peoples Health Mcr Adv $866 93%
Aetna $874 - $17,054 94%
Node First Choice Wellcare Mcr Adv $880 95%
Node Dignity Care Mcr Adv $891 96%
Node Champva $903 97%
Node Healthy Mississippi Mcr Adv $949 102%
Node Us Dept Of Labor $1,078 116%
Prime Health Wc $1,138 123%
Work Comp $1,173 127%
Molina Exchange $1,327 143%
Magnolia Exchange $1,510 163%
Medpartners $1,512 163%
Vantage Commercial $1,941 209%
Vantage Ppaca Tiered $1,984 214%
Humana $4,611 498%
Self Pay $5,443 587%
Ms Dept Of Rehabilitation Services $6,154 664%
Trimed Billing Solutions $9,071 979%
Prime Health Services $24,190 2611%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 52 Sergeant Prentiss Drive, Natchez, MS 39120
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals