CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Eastern New Mexico Medical Center

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$959

about 1.0× the $927 Medicare rate · typically $928–$1,028

modeled estimate · not a bill or quote

What this hospital charges insurers

$928

About the fair price

about $31 under the fair price · 1.0× Medicare

Medicare pays $927 Fair price $959 This hospital $928 Cash price $2,921 Hospital's list price $13,909

How we calculate the fair BaseRate →

How this hospital compares to other NM hospitals

One of the lower prices — 4 of 7 other NM hospitals charge more for the same procedure.

Cheapest $526 Priciest $1,571

Black dot = this hospital, among the 8 NM hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Upper endoscopy with biopsy is about $959 (about 1.0× the $927 Medicare rate). Eastern New Mexico Medical Center charges insurers about $928, or about $2,921 in cash — about the fair price. Located in Roswell, NM.

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	$788 - $8,693	85%
Blue Cross Blue Shieldmajor	$715 - $9,733	77%
Aetnamajor	$11,711	1264%
Cignamajor	$9,875	1066%
Humanamajor	$928	100%
Devoted Health	$928	100%
Molina	$892 - $2,451	96%
Presbyterian	$715 - $9,363	77%
+ 10 smaller / regional plans	$898 - $13,213

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 6 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 2,921), 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 Eastern New Mexico 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 Eastern New Mexico Medical Center

Compare: Upper endoscopy with biopsy at other NM hospitals

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