CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Monroe Regional Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$458

about 0.5× the $927 Medicare rate · typically $162–$1,479

modeled estimate · not a bill or quote

What this hospital charges insurers

$345

Below the fair price — a good deal

about $113 under the fair price · 0.4× Medicare

Medicare pays $927 Fair price $458 This hospital $345 Cash price $1,378 Hospital's list price $1,378

How we calculate the fair BaseRate →

How this hospital compares to other MS hospitals

A typical price — 4 charge more and 4 charge less, among the 9 MS hospitals compared.

Cheapest $86 Priciest $782

Black dot = this hospital, among the 9 MS hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $458 (about 0.5× the $927 Medicare rate). Monroe Regional Hospital charges insurers about $345, or about $1,378 in cash — below the fair price — a good deal. Located in Aberdeen, MS.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$298 - $1,768	32%
Aetnamajor	$358 - $2,122	39%
Ambetter (Centene)	$142 - $872	15%
+ 1 smaller / regional plan	$293 - $672

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,378), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 43239.

Insurance Before you use insurance

Call your insurance company to confirm Monroe Regional Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 43239.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Monroe Regional Hospital

Compare: Upper endoscopy with biopsy at other MS hospitals

Insurance negotiated median for the same procedure, sorted lowest first.