CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: University of Mississippi Medical Center- Grenada

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $831
Cash Discount Price: $742
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at University of Mississippi Medical Center- Grenada is $831. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $742. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.90x the Medicare baseline. Located in 960 Avent Drive, Grenada, MS.

Cash / Self-Pay

$742

Average discount available for prompt cash payment at this facility.

Insurance Median

$831

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: $742 (80%)

Insurance Median: $831 (90%)

Cash: $742 (80% of Medicare)

Ins. Median: $831 (90% 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
Advhealth-Gmc	$521	56%
Ms-Can-Molina-Gmc	$736	79%
Ms-Can-Magnolia-Gmc	$743	80%
Ms-Can-Truecare-Gmc	$750	81%
Medicare (plans)	$782	84%
Tricare	$782	84%
Va_Ccn-Gmc	$782	84%
Medadv_Primewell-Gmc	$805	87%
Medadv_Uhc-Gmc	$805	87%
Medadv_Uhcdsnp-Gmc	$805	87%
Wellcare-Gmc	$805	87%
Humana	$813	88%
Devoted_Health-Gmc	$821	89%
Blue Cross Blue Shield	$831	90%
Bhsg-Gmc	$1,298	140%
Firstchoice-Gmc	$1,564	169%
Mpcn-Gmc	$1,568	169%
Molina-Chip-Gmc	$1,572	170%
Magnolia-Chip-Gmc	$1,608	174%
Truecare-Chip-Gmc	$1,608	174%
Cigna	$1,632	176%
Aetna	$1,669	180%
Molina_Exchange-Gmc	$1,681	181%
Healthlink-Gmc	$1,715	185%
Ambetter / Centene	$1,854	200%
Primewell-Gmc	$1,854	200%
United-Gmc	$1,854	200%

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 $742.
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 University of Mississippi Medical Center- Grenada 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.