CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: New London Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 43239
Insurance Median: $883
Cash Discount Price: $1,079
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at New London Hospital is $883. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,079. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.95x the Medicare baseline. Located in 273 County Road, New London, NH.

Cash / Self-Pay

$1,079

Average discount available for prompt cash payment at this facility.

Insurance Median

$883

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: $1,079 (116%)

Insurance Median: $883 (95%)

Cash: $1,079 (116% of Medicare)

Ins. Median: $883 (95% 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
Blue Cross Blue Shield	$133 - $2,454	14%
Martin'S Point Generations Advantage	$133 - $1,318	14%
Martin'S Point Health Care	$133 - $2,059	14%
UnitedHealthcare	$133 - $2,343	14%
Wellcare Health Plans	$137 - $1,318	15%
Wellsense Health Plan	$140 - $1,318	15%
Granite State Health Plan	$142 - $1,512	15%
Amerihealth Caritas Nh	$143 - $1,527	15%
Aetna	$153 - $2,589	17%
Ambetter / Centene	$153 - $1,318	17%
Harvard Pilgrim Health Care Of Ne	$158 - $2,137	17%
Cigna	$185 - $2,028	20%
Tufts Health Plan	$1,195 - $2,157	129%
Coventry	$1,633 - $2,831	176%
Multiplan	$1,642 - $2,846	177%

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 $1,079.
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 New London Hospital 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.