CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Neshoba County General Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$496

about 0.5× the $927 Medicare rate · typically $480–$920

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $496 Cash price $502 Hospital's list price $717

How we calculate the fair BaseRate →

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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	$1,520	164%
Aetnamajor	$358	39%
Cignamajor	$466	50%
Humanamajor	$837	90%
GEHA	$645	70%
Molina	$630 - $837	68%
WellCare	$837	90%
+ 9 smaller / regional plans	$609 - $1,470

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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 502), 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 Neshoba County General 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 Neshoba County General Hospital

Compare: Upper endoscopy with biopsy at other MS hospitals

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