Upper endoscopy with biopsy
Facility: Dr Dan C Trigg Memorial Hospital
Billing Code: 43239 (CPT)
This hospital's typical commercial price is $1,037 compared to the $668 fair price benchmark.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
A typical price — 3 charge more and 5 charge less, among the 9 NM hospitals compared.
Black dot = this hospital, among the 9 NM hospitals with a price for this procedure. Full list below.
Note: 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 $668 (about 0.7× the $927 Medicare rate). Dr Dan C Trigg Memorial Hospital charges insurers about $1,037, or about $3,216 in cash — above the fair price. Located in Tucumcari, NM.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $668. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
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
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 | $976 | 105% |
| Blue Cross Blue Shieldmajor | $985 - $1,658 | 106% |
| Aetnamajor | $995 | 107% |
| Humanamajor | $1,033 | 111% |
| Molina | $1,014 | 109% |
| Presbyterian | $947 - $3,710 | 102% |
| + 1 smaller / regional plan | $1,042 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Dr Dan C Trigg Memorial Hospital
Compare: Upper endoscopy with biopsy at other NM hospitals
- Gila Regional Medical Center · Silver City $526
- UNM Hospital · Albuquerque $893
- Eastern New Mexico Medical Center · Roswell $928
- Mountain View Regional Medical Center · Las Cruces $928
- Covenant Health Hobbs Hospital · Hobbs $945
- Rehoboth McKinley Christian Health Care Services · Gallup $1,060
- Carlsbad Medical Center · Carlsbad $1,098
- Presbyterian Hospital · Albuquerque $1,571
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Dr Dan C Trigg Memorial Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $1,668
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $1,668).
Self-Pay Cash Rate ($3,216) Beats Your Bill
Dr Dan C Trigg Memorial Hospital's published 45 CFR § 180 self-pay cash rate is $3,216 (vs. $1,037 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $668 Fair BaseRate ($927 Medicare)
Your bill ($4,594) is $3,926 above the denoised Fair BaseRate ($668) and 5.0× the $927 Medicare rate.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.