CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Singing River Gulfport

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $786
Cash Discount Price: $3,119
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Singing River Gulfport is $786. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,119. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.85x the Medicare baseline. Located in 15200 Community Road, Gulfport, MS.

Cash / Self-Pay

$3,119

Average discount available for prompt cash payment at this facility.

Insurance Median

$786

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: $3,119 (337%)

Insurance Median: $786 (85%)

Cash: $3,119 (337% of Medicare)

Ins. Median: $786 (85% 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	$389 - $1,392	42%
UnitedHealthcare	$389 - $1,245	42%
Aetna	$397 - $2,010	43%
Humana	$397 - $794	43%
Blue Cross Blue Shield	$401 - $801	43%
Shared Health	$409 - $817	44%
Wellcare	$409 - $817	44%
Ambetter / Centene	$584 - $1,167	63%
Molina Healthcare Of Ms	$622 - $1,245	67%
Mississippi Physicians Care Network	$700 - $1,401	76%
90 Degree Benefits	$739 - $1,478	80%
Singing River Health System Employees	$993	107%

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 $3,119.
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 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.