CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Chilton Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,256

about 1.4× the $927 Medicare rate · typically $936–$2,282

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,088

Below the fair price — a good deal

about $168 under the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,256 This hospital $1,088 Cash price $1,251 Hospital's list price $12,253

How we calculate the fair BaseRate →

How this hospital compares to other NJ hospitals

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

Cheapest $623 Priciest $1,088

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

A fair price for a Upper endoscopy with biopsy is about $1,256 (about 1.4× the $927 Medicare rate). Chilton Medical Center charges insurers about $1,088, or about $1,251 in cash — below the fair price — a good deal. Located in Pompton Plains, NJ.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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	$1,088	117%
Aetnamajor	$1,088 - $1,523	117%
Cignamajor	$1,088	117%
Ambetter (Centene)	$1,088	117%
AmeriHealth	$1,088 - $4,096	117%
Health Net	$2,412	260%
UPMC Health Plan	$1,088	117%
WellCare	$1,088	117%
+ 25 smaller / regional plans	$275 - $12,000

Government programs also on file: Medicare, Medicaid, 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 1,251), 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 Chilton 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 (%)

Enter your details and press estimate to compare.

Other Procedures at Chilton Medical Center

Compare: Upper endoscopy with biopsy at other NJ hospitals

St Joseph's University Medical Center Inc · Paterson $623
Inspira Medical Center Vineland · Vineland $1,020
Inspira Medical Center Mullica Hill · Elmer $1,020
Newton Medical Center · Newton $1,024
AHS Hospital Corp · Hackettstown $1,024
Capital Health Regional Medical Center · Trenton $1,025
Centrastate Medical Center · Freehold $1,038
Jfk University Medical Center · Edison $1,039

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