CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Methodist Healthcare - Olive Branch Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $859
Cash Discount Price: $1,451
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Methodist Healthcare - Olive Branch Hospital is $859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,451. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.93x the Medicare baseline. Located in 4250 Bethel Road, Olive Branch, MS.

Cash / Self-Pay

$1,451

Average discount available for prompt cash payment at this facility.

Insurance Median

$859

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: $1,451 (157%)

Insurance Median: $859 (93%)

Cash: $1,451 (157% of Medicare)

Ins. Median: $859 (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.

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
Medicaid / KanCare	$297 - $688	32%
Blue Cross Blue Shield	$583 - $859	63%
UnitedHealthcare	$672 - $2,383	73%
Tricare	$811	88%
Molina Healthcare [350012]	$840	91%
American Health Advantage Mcr Adv [450117]	$859	93%
Carecentrix [450200]	$859	93%
Devoted Health [450111]	$859	93%
Generic Hospice Vbid [10940000101]	$859	93%
Humana	$859	93%
Medicare (plans)	$859	93%
Va Hospital [600005]	$859	93%
Cigna	$1,273 - $1,792	137%
United Food & Commercial Workers [100309]	$1,792	193%
Langston Performance Health [100405]	$3,463	374%

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 $1,451.
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 Methodist Healthcare - Olive Branch Hospital 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.