CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Incline Village Community Hospital

Billing Code: 43239 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$262

about 0.3× the $927 Medicare rate · typically $180–$1,652

modeled estimate · not a bill or quote

What this hospital charges insurers

$154

Below the fair price — a good deal

about $108 under the fair price · 0.2× Medicare

Medicare pays $927 Fair price $262 This hospital $154 Cash price $751 Hospital's list price $751

How we calculate the fair BaseRate →

How this hospital compares to other NV hospitals

Lowest price of the 9 NV hospitals we have prices for — a strong deal.

Cheapest $154 Priciest $1,036

Black dot = this hospital, among the 9 NV 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 $262 (about 0.3× the $927 Medicare rate). Incline Village Community Hospital charges insurers about $154, or about $751 in cash — below the fair price — a good deal. Located in Incline Village, NV.

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	$246	27%
Blue Cross Blue Shieldmajor	$141 - $676	15%
Aetnamajor	$661	71%
Cignamajor	$691	75%
Humanamajor	$676	73%
Health Net	$165	18%
+ 6 smaller / regional plans	$144 - $728

Government programs also on file: Medicare.

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 751), 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 Incline Village Community 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 Incline Village Community Hospital

Compare: Upper endoscopy with biopsy at other NV hospitals

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