Upper endoscopy with biopsy
Facility: Newton Medical Center
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $1,024
- Cash Discount Price: $1,523
- vs. Medicare Baseline: 1.11x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Wtc Health Program [5273] | $275 | 30% |
| Aetna | $1,024 - $1,434 | 111% |
| Ambetter / Centene | $1,024 | 111% |
| Amerihealth Administrators Supplemental [5512] | $1,024 | 111% |
| Amerihealth Medigap [5049] | $1,024 | 111% |
| Blue Cross Blue Shield | $1,024 - $11,952 | 111% |
| Champva [5354] | $1,024 | 111% |
| Cigna | $1,024 | 111% |
| Claim Watcher/Homestead [5488] | $1,024 | 111% |
| Claimdoc [5434] | $1,024 | 111% |
| Cosmetic Surgery/Lap Band/Gastric Bypass [5289] | $1,024 | 111% |
| Fairos [5491] | $1,024 | 111% |
| Highmark Wholecare Health Plan Ip Splits [5464] | $1,024 | 111% |
| Highmark Wholecare Health Plan [5413] | $1,024 | 111% |
| Karen Ann Quinlan [5285] | $1,024 | 111% |
| Luminare Health AHS Retiree [5013] | $1,024 | 111% |
| Medicaid / KanCare | $1,024 | 111% |
| Medicare (plans) | $1,024 - $1,060 | 111% |
| Sedgwick Wtc Health Program Wc [5514] | $1,024 | 111% |
| Specialty Imaging [5433] | $1,024 | 111% |
| Tricare | $1,024 | 111% |
| UPMC [5455] | $1,024 | 111% |
| Us Family Health Plan [5258] | $1,024 | 111% |
| VA Community Care Network [5403] | $1,024 | 111% |
| Wellcare Behavioral Health [5335] | $1,024 | 111% |
| Wellcare Health Plans Ip Splits [5475] | $1,024 | 111% |
| Wellcare Health Plans [5269] | $1,024 | 111% |
| Amerihealth Caritas Vip Care Ip Splits [5460] | $1,035 | 112% |
| Amerihealth Caritas Vip Care [5313] | $1,035 | 112% |
| Kindred Giralda Hospital [5341] | $1,127 | 122% |
| Allstate [5047] | $2,412 | 260% |
| Esurance No Fault [5105] | $2,412 | 260% |
| Geico No Fault [5120] | $2,412 | 260% |
| Hanover No Fault [5129] | $2,412 | 260% |
| High Point No Fault [5146] | $2,412 | 260% |
| Liberty Mutual No Fault [5173] | $2,412 | 260% |
| Medlogix/Consumer Health Network Pip (Chn) [5414] | $2,412 | 260% |
| Nj Manufacturers No Fault [5203] | $2,412 | 260% |
| Plymouth Rock Assurance No Fault [5222] | $2,412 | 260% |
| Progressive No Fault [5229] | $2,412 | 260% |
| State Farm No Fault [5241] | $2,412 | 260% |
| Travelers No Fault [5249] | $2,412 | 260% |
| Usaa No Fault [5260] | $2,412 | 260% |
| Zurich No Fault [5274] | $2,412 | 260% |
| Horizon Nj Health [5021] | $3,167 | 342% |
| Amerihealth [5008] | $3,331 - $4,096 | 359% |
| Kessler Foundation [5532] | $12,000 | 1295% |