CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: Incline Village Community Hospital

Billing Code: 43239 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 43239
  • Insurance Median: $676
  • Cash Discount Price: $751
  • vs. Medicare Baseline: 0.73x Medicare
The contracted insurance negotiated median rate for a Upper endoscopy with biopsy at Incline Village Community Hospital is $676. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $751. Compared to the federal Medicare reimbursement reference rate of $926.63, this hospital’s rate is 0.73x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.
Cash / Self-Pay
$751

Average discount available for prompt cash payment at this facility.

Insurance Median
$676

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$926.63

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $926.63 (100%)
Cash / Self-Pay: $751 (81%)
Insurance Median: $676 (73%)
Cash: $751 (81% of Medicare)
Ins. Median: $676 (73% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $122 13%
Blue Cross Blue Shield $141 - $676 15%
Ca Hlth And Wellness - All Plans $144 16%
Healthnet - All Plans $165 18%
UnitedHealthcare $246 27%
Aetna $661 71%
Prominence Healthfirst - All Plans $661 71%
Admar Multiplan - All Plans $676 73%
First Health - All Plans $676 73%
Great West/One Health - All Plans $676 73%
Hometown Hp - All Plans $676 73%
Humana $676 73%
Interplan - All Plans $676 73%
Multiplan - All Plans $676 73%
Phcs - All Plans $676 73%
Cigna $691 75%
Beech Street/Capp Care - All Plans $713 77%
Uhn - All Plans $713 77%
Sierra Health - All Plans $728 79%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 880 Alder Street, Incline Village, NV 89451
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals