Upper endoscopy with biopsy
Facility: Merit Health River Oaks
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,332
- Cash Discount Price: $6,233
- vs. Medicare Baseline: 1.44x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 - $5,280 | 77% |
| UnitedHealthcare | $714 - $9,245 | 77% |
| Magnolia Mcd Chip | $722 | 78% |
| Caresource Truecare | $729 | 79% |
| Molina Chip | $772 | 83% |
| Humana | $806 | 87% |
| Medicare (plans) | $806 | 87% |
| Node First Choice Shared Health Of Ms Mcr Adv | $806 | 87% |
| Node Vantage Health Mcr Adv | $806 | 87% |
| Node Hospice Non Par Agree | $819 | 88% |
| Node Va | $819 | 88% |
| Molina | $822 | 89% |
| Node Devoted Health Mcr Adv | $822 | 89% |
| Node First Choice American Health Mcr Adv | $822 | 89% |
| Aetna | $830 - $24,238 | 90% |
| Node First Choice Wellcare Mcr Adv | $835 | 90% |
| Node Healthy Mississippi Mcr Adv | $901 | 97% |
| Node Us Dept Of Labor | $1,024 | 111% |
| Ms Work Comp | $1,173 | 127% |
| Prime Health Wc | $1,173 | 127% |
| First Choice Preferred | $1,228 | 133% |
| Node First Choice Occunet | $1,228 | 133% |
| Molina Exchange | $1,272 | 137% |
| Node First Choice Seven Corners | $1,392 | 150% |
| Magnolia Exchange | $1,433 | 155% |
| First Choice Lgp | $1,785 | 193% |
| Vantage Health Commercial | $1,842 | 199% |
| Tricare | $3,716 | 401% |
| Node Champva | $3,911 | 422% |
| Cigna | $6,891 | 744% |
| Ms Dept Of Rehabilitation Services | $7,381 | 797% |
| Self Pay | $7,618 | 822% |
| Trimed Billing Solutions | $10,388 | 1121% |
| Ms State Hospital Of Whitfield Ms | $13,158 | 1420% |
| First Choice Standard | $15,928 | 1719% |
| First Choice Coventry | $18,006 | 1943% |
| First Choice Mpcn Standard | $19,044 | 2055% |
| First Choice Ppo Plus | $19,044 | 2055% |
| Phcs | $20,776 | 2242% |
| First Choice Stratose | $27,701 | 2989% |
| Prime Health Services | $27,701 | 2989% |
| American Health Group | $29,432 | 3176% |
| Beech Street | $29,432 | 3176% |
| Benefit Administration Services | $29,432 | 3176% |
| Benefit Management Systems | $29,432 | 3176% |
| Citizens State Bank Inc | $29,432 | 3176% |
| Formost | $29,432 | 3176% |
| Usa Mco | $29,432 | 3176% |
| One Health Plan | $31,163 | 3363% |