CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Ocean Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,286

about 1.4× the $927 Medicare rate · typically $1,054–$2,380

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,153

Below the fair price — a good deal

about $133 under the fair price · 1.2× Medicare

Medicare pays $927 Fair price $1,286 This hospital $1,153 Cash price $981 Hospital's list price $4,106

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 $1,153

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 $1,286 (about 1.4× the $927 Medicare rate). Ocean Medical Center charges insurers about $1,153, or about $981 in cash — below the fair price — a good deal. Located in Brick, NJ.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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	$984 - $7,714	106%
Blue Cross Blue Shieldmajor	$1,025	111%
Aetnamajor	$583 - $8,419	63%
Cignamajor	$3,137 - $3,716	339%
Amerigroup	$938	101%
AmeriHealth	$3,528 - $3,996	381%
Clover Health	$739	80%
WellCare	$938 - $1,025	101%
+ 9 smaller / regional plans	$282 - $10,671

Government programs also on file: Military & VA.

Excludes 2 rental-network / third-party entries (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 981), 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 Ocean 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 Ocean 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.