CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Englewood Hospital and Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,349

about 1.5× the $927 Medicare rate · typically $1,077–$2,401

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,104

Below the fair price — a good deal

about $245 under the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,349 This hospital $1,104

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 $1,104

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 $1,349 (about 1.5× the $927 Medicare rate). Englewood Hospital and Medical Center charges insurers about $1,104 — below the fair price — a good deal. Located in Englewood, NJ.

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	$1,104 - $4,954	119%
Blue Cross Blue Shieldmajor	$1,104	119%
Aetnamajor	$1,104 - $1,822	119%
Cignamajor	$5,713	617%
Humanamajor	$1,104	119%
Amerigroup	$1,104	119%
AmeriHealth	$1,104 - $1,986	119%
Clover Health	$1,104	119%
MagnaCare	$3,410 - $3,978	368%
WellCare	$1,192	129%
+ 7 smaller / regional plans	$320 - $4,865

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, 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 Englewood Hospital and 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 Englewood Hospital and 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.