CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Regional West Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$341

about 0.4× the $927 Medicare rate · typically $316–$985

modeled estimate · not a bill or quote

What this hospital charges insurers

$317

About the fair price

about $24 under the fair price · 0.3× Medicare

Medicare pays $927 Fair price $341 This hospital $317 Cash price $2,073 Hospital's list price $3,455

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

Highest price of the 9 NE hospitals we have prices for — worth calling around.

Cheapest $122 Priciest $317

Black dot = this hospital, among the 9 NE 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 $341 (about 0.4× the $927 Medicare rate). Regional West Medical Center charges insurers about $317, or about $2,073 in cash — about the fair price. Located in Scottsbluff, NE.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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
UnitedHealthcaremajor	$465 - $3,109	50%
Blue Cross Blue Shieldmajor	$696 - $2,764	75%
Aetnamajor	$115 - $3,213	12%
Cignamajor	$317 - $3,109	34%
Humanamajor	$115 - $942	12%
Ambetter (Centene)	$269 - $1,413	29%
Medica	$115 - $2,937	12%
WellCare	$121 - $989	13%
+ 2 smaller / regional plans	$219 - $2,937

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 2,073), 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 Regional West Medical Center 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 (%)

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Other Procedures at Regional West Medical Center

Compare: Upper endoscopy with biopsy at other NE hospitals

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