CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Artesia General Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$1,086

about 1.2× the $927 Medicare rate · typically $955–$1,086

modeled estimate · not a bill or quote

Medicare pays $927 Fair price $1,086 Cash price $265 Hospital's list price $442

How we calculate the fair BaseRate →

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✓ Cigna✓ Humana AetnaKaiser 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	$411 - $908	44%
Blue Cross Blue Shieldmajor	$265 - $908	29%
Cignamajor	$376 - $398	41%
Humanamajor	$908 - $999	98%
GEHA	$309 - $908	33%
Molina	$715 - $1,526	77%
Presbyterian	$715 - $908	77%
+ 5 smaller / regional plans	$309 - $1,817

Government programs also on file: Military & VA.

Excludes 5 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 265), 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 Artesia General Hospital 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 Artesia General Hospital

Compare: Upper endoscopy with biopsy at other NM hospitals

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