Upper endoscopy with biopsy
Facility: Atlanticare Regional Medical Center - City Campus
Billing Code: 43239 (CPT)
- CPT Billing Code: 43239
- Insurance Median: $4,786
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 5.16x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 516% of the Medicare baseline (a markup of 416%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Americhoice | $824 | 89% |
| UnitedHealthcare | $824 - $4,534 | 89% |
| Wellcare | $882 | 95% |
| Horizon | $888 - $4,470 | 96% |
| Tricare | $938 | 101% |
| Self Pay | $958 | 103% |
| Devoted Health Plan | $1,020 - $3,193 | 110% |
| Global Exchange Managed Care | $1,531 | 165% |
| Health Partners Plan | $1,596 - $2,041 | 172% |
| Amerigroup | $1,660 | 179% |
| Magnacare | $2,554 - $5,747 | 276% |
| Cigna | $3,016 - $3,506 | 325% |
| Evernorth | $3,193 | 345% |
| Qualcare Commercial | $3,193 | 345% |
| Great West Life | $3,506 | 378% |
| Amerihealth | $3,623 - $4,783 | 391% |
| Active Care Plus | $4,151 | 448% |
| First Mco | $4,151 | 448% |
| Mutual Of Omaha | $4,151 | 448% |
| Qualcare Wc | $4,151 | 448% |
| Aetna | $4,470 - $9,272 | 482% |
| Consumer Health Network (Chn) | $4,470 - $5,747 | 482% |
| Donio Trucking | $4,470 | 482% |
| Devon/ Ullicare | $4,790 | 517% |
| Oxford | $4,790 | 517% |
| Coventry Health Care | $5,109 | 551% |
| Private Healthcare System (Phcs) | $5,109 | 551% |
| Blue Cross Blue Shield | $5,254 | 567% |
| Health Payors Org | $5,428 | 586% |
| Health South | $5,428 | 586% |
| Metrahealth Of Nj | $5,428 | 586% |
| Prime Health Services | $5,428 | 586% |
| Three Rivers Provider Network (Trpn) | $5,428 | 586% |
| Active Care Nj Pip | $5,747 | 620% |
| Beech Street | $5,747 | 620% |
| Choice Care | $5,747 | 620% |
| Department Of Corrections | $5,747 | 620% |
| Galaxy Health Network | $5,747 | 620% |
| Health Network Inc | $5,747 | 620% |
| Intergroup Preferred Program | $5,747 | 620% |
| Mcs Commercial | $5,747 | 620% |
| Metracomp | $5,747 | 620% |
| Multiplan | $5,747 | 620% |
| Provider Select, Inc | $5,747 | 620% |
| Atlantis Health Plan | $5,907 | 637% |
| Master Care Inc | $5,907 | 637% |
| Advance Healthcare System | $6,067 | 655% |
| Community Care Network | $6,067 | 655% |
| Health Network America | $6,067 | 655% |
| Mcsi/Mrsi No Fault | $6,067 | 655% |
| Mcsi/Mrsi Worker'S Comp | $6,067 | 655% |
| National Health Plan | $6,067 | 655% |