CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Stillwater Billings Clinic

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $479
  • Cash Discount Price: $624
  • vs. Medicare Baseline: 0.52x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Stillwater Billings Clinic is $479. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $624. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.52x the Medicare baseline. Located in 710 N 11Th St, Columbus, MT.
Cash / Self-Pay
$624

Average discount available for prompt cash payment at this facility.

Insurance Median
$479

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: $624 (67%)
Insurance Median: $479 (52%)
Cash: $624 (67% of Medicare)
Ins. Median: $479 (52% 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
Humana $132 - $595 14%
Pacific Source Mcr Advantage $132 - $589 14%
Tricare $132 - $589 14%
Blue Cross Blue Shield $134 - $866 14%
Allegiance Direct Ppo - All Other Plans $217 - $823 23%
Allegiance State Of Mt $217 - $1,212 23%
All Savers-All Plans $219 - $823 24%
UnitedHealthcare $219 - $823 24%
Cigna $234 - $823 25%
Mountain Health Coop - All Plans $237 - $797 26%
Pacific Source Billings Clinic $237 - $650 26%
Pacific Source Voyager - All Other Plans $237 - $823 26%
Pacificsource Nav $237 - $823 26%
Aetna $238 - $840 26%
Boon Chapman First Choice Health $238 - $840 26%
Ebms First Choice Health $238 - $840 26%
First Choice- All Plans $238 - $840 26%
Rci First Choice Health - All Other Plans $238 - $840 26%
Rci Wyoben $238 - $779 26%
Trustmark First Choice Health $238 - $840 26%
Wyo-Ben Inc- All Plans $238 - $779 26%
Zenith First Choice Health- All Plans $238 - $840 26%
Pacific Steel Direct - All Plans $265 - $606 29%
Ebms Interwest $316 - $823 34%
Gpa Interwest- All Plans $316 - $823 34%
Interwest Health-All Plans $316 - $823 34%
Rci Interwest $316 - $823 34%
Allied Core Value $331 - $753 36%
Ebms Town Pump $343 - $823 37%
Town Pump Inc- All Plans $343 - $823 37%
Blackhawk - All Plans $362 - $823 39%
Mtada- All Plans $362 - $823 39%
Prodegi (Y-Tex Corp)- All Plans $362 - $823 39%
Murdoch Oil - All Plans $370 - $840 40%
Ryegate Public Schools - All Plans $370 - $840 40%
Savatree - All Plans $370 - $840 40%
Tabs - All Plans $370 - $840 40%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 710 N 11Th St, Columbus, MT 59019
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals