CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Ochsner Medical Center-Hancock

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $865
  • Cash Discount Price: $565
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Ochsner Medical Center-Hancock is $865. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $565. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.93x the Medicare baseline. Located in 149 Drinkwater Blvd, Bay Saint Louis, MS.
Cash / Self-Pay
$565

Average discount available for prompt cash payment at this facility.

Insurance Median
$865

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: $565 (61%)
Insurance Median: $865 (93%)
Cash: $565 (61% of Medicare)
Ins. Median: $865 (93% 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
Blue Cross Blue Shield $521 - $542 56%
Cigna $595 - $861 64%
Medicaid / KanCare $672 - $705 73%
Mississippi Physicians Care Network $744 80%
Zelis $773 83%
Humana $775 - $861 84%
Magnolia Health Plan – Wellcare By All Well Of Mississippi $861 93%
Medicare (plans) $861 - $904 93%
UnitedHealthcare $861 - $2,959 93%
Aetna $869 - $1,160 94%
Shared Health Mississippi $904 98%
Claritev D/B/A Multiplan/Phcs/American Life Care $952 103%
Healthcomp & Personify Health (Formerly Gilsbar) $1,041 112%
Select Administrative Services Network $1,041 112%
Ambetter / Centene $1,377 149%
Primewell Health Services Commercial Exchange Plan $2,410 260%
Primewell Health Services – Commercial $2,410 260%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 149 Drinkwater Blvd, Bay Saint Louis, MS 39520
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals